Journal of psychosomatic research · 2026
Factors associated with psychological distress in patients with bone tumors and 3-month changes during routine psychological management: A prospective observational study.
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Yan Yu, Qiu Jianglan, Yang Dan, Tang Tingting, Liu Xiaoyan
Аннотация
OBJECTIVE: To examine clinical, functional, and psychosocial factors associated with psychological distress in patients with bone tumors and describe within-group changes during routine psychological management.
METHODS: This prospective observational study included 160 patients with primary bone tumors. The primary analysis was cross-sectional because the explanatory variables and psychological distress were assessed concurrently at baseline. Multiple linear regression was used to examine factors associated with the continuous Symptom Checklist-90 (SCL-90) total score. Logistic regression based on screening status was performed as a supplementary analysis. Patients who screened positive received routine individualized psychological and supportive management and underwent reassessment after 3 months.
RESULTS: Fifty-two patients (32.5%) screened positive for psychological distress. Higher Visual Analog Scale (VAS), Body Image Scale (BIS), and Fear of Progression Questionnaire-Short Form (FoP-Q-SF) scores were associated with higher SCL-90 total scores, whereas higher Musculoskeletal Tumor Society (MSTS) and Social Support Rating Scale (SSRS) scores were associated with lower SCL-90 scores (all P < 0.01). The primary model explained 71.9% of the variance in SCL-90 scores. No important multicollinearity was detected. Among the 52 screening-positive patients, most SCL-90 dimension scores and the total score decreased at 3 months, whereas the change in paranoid ideation was not statistically significant.
CONCLUSION: Greater pain, body image disturbance, fear of progression, poorer limb function, and lower social support were associated with greater psychological distress. Symptom scores decreased among screening-positive patients, but without a comparison group, these findings are descriptive and hypothesis-generating, not evidence of management effects.
METHODS: This prospective observational study included 160 patients with primary bone tumors. The primary analysis was cross-sectional because the explanatory variables and psychological distress were assessed concurrently at baseline. Multiple linear regression was used to examine factors associated with the continuous Symptom Checklist-90 (SCL-90) total score. Logistic regression based on screening status was performed as a supplementary analysis. Patients who screened positive received routine individualized psychological and supportive management and underwent reassessment after 3 months.
RESULTS: Fifty-two patients (32.5%) screened positive for psychological distress. Higher Visual Analog Scale (VAS), Body Image Scale (BIS), and Fear of Progression Questionnaire-Short Form (FoP-Q-SF) scores were associated with higher SCL-90 total scores, whereas higher Musculoskeletal Tumor Society (MSTS) and Social Support Rating Scale (SSRS) scores were associated with lower SCL-90 scores (all P < 0.01). The primary model explained 71.9% of the variance in SCL-90 scores. No important multicollinearity was detected. Among the 52 screening-positive patients, most SCL-90 dimension scores and the total score decreased at 3 months, whereas the change in paranoid ideation was not statistically significant.
CONCLUSION: Greater pain, body image disturbance, fear of progression, poorer limb function, and lower social support were associated with greater psychological distress. Symptom scores decreased among screening-positive patients, but without a comparison group, these findings are descriptive and hypothesis-generating, not evidence of management effects.