I’ll do it myself: understanding low psychological care uptake in cancer patients with depressive symptoms

About a quarter of all people with cancer experience increased levels of depressive symptoms. However, the majority do not receive psychological care – often because they do not want such care. This dissertation investigates why this is the case. The results show that if people with cancer experience mild levels of depressive symptoms, or mainly experience physical depressive symptoms (such as fatigue or concentration problems) they are less likely to recognize these symptoms as depressive symptoms and therefore have a lower need for psychological care. In addition, a large group has no need for psychological care because they have little confidence in such care. Cancer patients who deal with their complaints in an avoidant way, often have a need for psychological care, but may not receive this because they find it difficult to truly seek such care. The results also showed that people mainly need care for fatigue, sleep problems, feeling down and little enjoyment. Fatigue, worrying and concentration problems often lead to more sad moods and less enjoyment later on, and may therefore be important to focus on in future interventions. Besides that, it also showed that people with cancer are often unable to reduce their depressive symptoms themselves. This thesis shows how important it is to increase the knowledge and recognition of depressive symptoms in people with cancer, and to better inform them about the effectiveness of psychological treatments, the possible risks of self-management and the role of avoidant coping in dealing with depressive symptoms and finding adequate care