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The patients also completed the Brief Symptom Inventory\u201053 to assess hostility (BSI\u2010HOS), and the Mini\u2010Mental Adjustment to cancer scale (Mini\u2010MAC). A subset of patients completed the Cancer Worries Inventory (CWI), the Openness Scale, and the Quality of Life Index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>By analyzing the distribution of the responses 25% of the patients had moderate and 11% high levels of hostility, with about 20% being BSI\u2010HOS \u201ccases.\u201d Hostility was higher in patients with a formal ICD\u201010 psychiatric diagnosis (mainly major depression, other depressive disorders, anxiety disorders) than patients without ICD\u201010 diagnosis. However, about 25% of ICD\u201010\u2010non cases also had moderate\u2010to\u2010high hostility levels. Hostility was associated with Mini\u2010MAC hopelessness and anxious preoccupation, poorer quality of life, worries (mainly problems sin interpersonal relationships), and inability to openly discuss these problems within the family.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hostility and its components should be considered as dimensions to be more carefully explored in screening for distress in cancer clinical settings for its implications in negatively impacting on quality of life, coping and relationships with the family, and possibly the health care system.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.5594","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T13:11:36Z","timestamp":1605705096000},"page":"493-503","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Hostility in cancer patients as an underexplored facet of distress"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1050-4494","authenticated-orcid":false,"given":"Luigi","family":"Grassi","sequence":"first","affiliation":[{"name":"Department of Neuroscience and Rehabilitation Institute of Psychiatry University of Ferrara  Ferrara Italy"},{"name":"Department of Mental Health University Unit of Hospital Psychiatry, S. Anna University Hospital and Ferarra Health Trust  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martino","family":"Belvederi Murri","sequence":"additional","affiliation":[{"name":"Department of Neuroscience and Rehabilitation Institute of Psychiatry University of Ferrara  Ferrara Italy"},{"name":"Department of Mental Health University Unit of Hospital Psychiatry, S. Anna University Hospital and Ferarra Health Trust  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Riba","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Psychiatry University of Michigan Depression Center  Ann Arbor Michigan USA"},{"name":"University of Michigan Rogel Cancer Center Psycho\u2010oncology Program  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"de Padova","sequence":"additional","affiliation":[{"name":"Psycho\u2010Oncology Unit Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS  Meldola Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Bertelli","sequence":"additional","affiliation":[{"name":"Psycho\u2010Oncology Unit Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS  Meldola Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana","family":"Sabato","sequence":"additional","affiliation":[{"name":"Department of Neuroscience and Rehabilitation Institute of Psychiatry University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Giulia","family":"Nanni","sequence":"additional","affiliation":[{"name":"Department of Neuroscience and Rehabilitation Institute of Psychiatry University of Ferrara  Ferrara Italy"},{"name":"Department of Mental Health University Unit of Hospital Psychiatry, S. 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