The psychological distress and care needs of mesothelioma patients and asbestos-exposed subjects: A systematic review of published studies

Our plain-English summary of The psychological distress and care needs of mesothelioma patients and asbestos-exposed subjects: A systematic review of published studies, by M. Bonafede, M. Ghelli, M. Corfiati, et al (American Journal of Industrial Medicine, 2018).

The study

• Authors: M. Bonafede, M. Ghelli, M. Corfiati, V. Rosa, F. Guglielmucci, A. Granieri, C. Branchi, S. Iavicoli, A. Marinaccio
• Journal: American Journal of Industrial Medicine
• Published: 2018;61(5):400-412
• Type of article: Systematic review
• Cited by: 25 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: The purpose of this study is to present the results of a systematic review of published research that focuses on psychological aspects of malignant mesothelioma patients and asbestos-exposed people.

Methods: Our research includes primary studies published between 1980 and 2016, using information from the Cochrane Library, the Psychology Behavioral Sciences Collection, PsychINFO, PubMed, PubGet, PubPsych, and Scopus, in compliance with PRISMA guidelines.

Results: We identified 12 papers that investigated the psychological distress and care needs of mesothelioma patients, and nine papers for asbestos-exposed subjects.

Conclusions: This paper highlights the paucity of studies on the psychological distress and care needs of mesothelioma patients and asbestos-exposed subjects. It confirms that malignant mesothelioma is associated with the physical, emotional, and social functioning of patients, while also suggesting that the risk of developing asbestos-related diseases among asbestos-exposed subjects is associated with high levels of psychological distress, despair, and mental health difficulties.

© 2018 Wiley Periodicals, Inc.

In plain English

This article was a systematic review, not a new study. The authors searched seven databases for studies published from 1980 to 2016 on the psychological aspects of malignant mesothelioma patients and of asbestos-exposed people. From 11 758 records for patients and 716 for exposed subjects, they kept 12 papers on mesothelioma patients and nine on asbestos-exposed subjects, from eight countries. Because the studies differed in design and tools, the authors calculated no pooled estimate. They did not assess risk of bias, citing their primary aim of investigating psychological aspects. They summarized findings by theme. Many included studies described shock and dismay at diagnosis among patients, and avoidance and denial as patients' main coping strategies. Several studies reported that both exposed and non-exposed people could develop anxiety and depressive symptoms even without disease. One study found no significant difference in distress between exposed and non-exposed people. The authors concluded that few studies exist on this topic. They also concluded that, among exposed subjects, the risk of asbestos-related disease is often associated with high psychological distress, despair and mental health problems.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Systematic review of published studies (qualitative and quantitative), following PRISMA guidelines, with a narrative synthesis and no pooled estimate
• Who was studied: Primary studies published 1980 to 2016 in Italian, English, French or Spanish, found in the Cochrane Library, Psychology Behavioral Sciences Collection, PsychINFO, PubMed, PubGet, PubPsych and Scopus. Two groups were reviewed: people diagnosed with malignant mesothelioma (12 papers) and asbestos-exposed subjects (9 papers). The authors defined the exposed group as free of asbestos-related disease, but one included study (Barak et al) involved workers with asbestosis. Study sizes ranged from 6 to 63 mesothelioma patients and from 16 to 3122 exposed subjects.
• Exposure: Asbestos exposure, which the review classified as occupational, familial (living with exposed workers, for example through soiled work clothes), environmental (living near a contaminated site) or leisure (hobbies, home renovations). The authors defined the 'exposed' group as people exposed to asbestos fibers but free from asbestos-related diseases. However, Table 2 lists one included study of electrical power plant workers with asbestosis.
• Main results:
  • The search produced 11 758 potential articles for patients and 716 for exposed subjects. After screening, 79 eligible articles remained (58 for patients and 21 for exposed subjects).
  • The authors included 12 papers on mesothelioma patients and nine papers on asbestos-exposed subjects.
  • The included studies came from Australia (5), the United Kingdom (4), Italy (3), France (3), the United States (3), China (1), Israel (1) and Switzerland (1).
  • Among mesothelioma patients, many included studies detected shock and dismay at diagnosis.
  • Among patients, avoidance and denial were the predominant coping mechanisms reported in the included studies.
  • Among studies of exposed subjects, many reported that both asbestos-exposed and non-exposed subjects can develop anxiety and depressive symptoms even in the absence of disease.
  • Only one included study reported no significant difference in psychological distress between exposed and non-exposed people.
• The authors' conclusion: The authors concluded that there are few studies on the psychological distress and care needs of mesothelioma patients and asbestos-exposed subjects. They also concluded that mesothelioma is associated with patients' physical, emotional and social functioning, and that among exposed subjects the risk of asbestos-related disease is often associated with high psychological distress, despair and mental health problems. They called for multidisciplinary interventions that include psychological assessment and support.
• Limitations the authors state:
  • No pooled analysis was possible because the included studies and their assessment tools were too varied.
  • The authors did not assess the risk of bias in the included studies. They explained this by pointing to their primary aim of investigating psychological aspects.
  • The varied nature of the studies did not allow diagnosable levels of psychopathology to be identified.
  • No reliable tools exist that produce consistent data for this specific population.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Systematic Review.

Related studies

• A systematic literature review comparing the psychological care needs of patients with mesothelioma and advanced lung cancer — H. Ball, S. Moore, et al. (2016)
• Psychological Distress in Patients With Asbestos-Related Diseases and Their Families: A Systematic Literature Review — I.G. Franzoi, M.D. Sauta, et al. (2025)
• A tailored, supportive care intervention using systematic assessment designed for people with inoperable lung cancer: a randomised controlled trial — P. Schofield, A. Ugalde, et al. (2013)
• Psychological Distress after a Diagnosis of Malignant Mesothelioma in a Group of Patients and Caregivers at the National Priority Contaminated Site of Casale Monferrato — M. Bonafede, A. Granieri, et al. (2020)
• Preliminary validation of a questionnaire assessing psychological distress in caregivers of patients with malignant mesothelioma: Mesothelioma Psychological Distress Tool-Caregivers — M. Bonafede, C. Chiorri, et al. (2022)
• Preliminary validation of a brief PROM assessing psychological distress in patients with malignant mesothelioma: The mesothelioma psychological distress tool-Patients — F. Guglielmucci, M. Bonafede, et al. (2022)

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