Relationship between physicians' perceived stigma toward depression and physician referral to psycho‐oncology services on an oncology/hematology ward

Objective This study was performed to identify relationships between physicians' perceived stigma toward depression and psycho‐oncology service utilization on an oncology/hematology ward. Methods The study participants were 235 patients in an oncology/hematology ward and 14 physicians undergoing an internal medicine residency training program in Inha University Hospital (Incheon, South Korea). Patients completed the Patient Health Questionnaire‐9 (PHQ‐9), and residents completed the Perceived Devaluation‐Discrimination scale that evaluates perceived stigma toward depression. A total PHQ‐9 score of ≥5 was defined as clinically significant depression. Physicians decided on referral on the basis of their opinions and those of their patients. The correlates of physicians' recommendation for referral to psycho‐oncology services and real referrals psycho‐oncology services were examined. Results Of the 235 patients, 143 had PHQ‐9 determined depression, and of these 143 patients, 61 received psycho‐oncology services. Physicians recommended that 87 patients consult psycho‐oncology services. Multivariate analyses showed that lower physicians' perceived stigma regarding depression was significantly associated with physicians' recommendation for referral, and that real referral to psycho‐oncology services was significantly associated with presence of a hematologic malignancy and lower physicians' perceived stigma toward depression. Conclusion Physicians' perceived stigma toward depression was found to be associated with real referral to psycho‐oncology services and with physician recommendation for referral to psycho‐oncology services. Further investigations will be needed to examine how to reduce physicians' perceived stigma toward depression.