{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:27:28Z","timestamp":1792182448222,"version":"4.4.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Primary bone tumors, though rare, impose significant psychological stress due to chronic pain, disfigurement, and functional limitations. In developing countries like India, this burden is compounded by limited access to mental health services, economic strain, and social stigma. However, data focusing on the psychological impact of bone tumors in Indian populations remain sparse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A cross-sectional observational study was conducted on 80 patients aged 18\u201350 years with histologically confirmed primary bone tumors between April 2023 and September 2024. Psychological distress was assessed using validated tools: Depression, Anxiety, and Stress Scale-21 (DASS-21), Perceived Stress Scale (PSS), and World Health Organization Quality of Life \u2013 Brief Version (WHOQOL-BREF) (quality of life [QoL]). Associations with sociodemographic and clinical variables were statistically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among the 80 patients, 58% were male, and the mean age was 31.08 \u00b1 6.69 years. Severe-to-extremely severe psychological distress (DASS-21 score &gt;35) was found in 57.5% of participants. Moderate-to-high perceived stress (PSS score &gt;30) was present in 90% of cases. Poor-to-moderate QoL (WHOQOL-BREF score &lt;45) was observed in 85% of patients. Psychological distress was significantly higher in patients with malignant tumors compared to benign ones (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.005). Other significant risk factors included younger age, lower income, rural background, and nuclear family structure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Psychological distress is highly prevalent among patients with primary bone tumors, particularly those with malignant pathology. Routine psychological screening and early psychosocial interventions should be integrated into orthopedic oncology care, especially in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aam.aam_425_25","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T15:00:10Z","timestamp":1764082810000},"page":"1614-1618","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence of Psychological Distress and its Risk Factors in Patients with Primary Bone Tumors \u2013 A Cross-sectional Single-center Study"],"prefix":"10.4103","volume":"25","author":[{"given":"Deepak","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shailendra","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujeet Kumar","family":"Chaudhary","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mithilesh","family":"Kannaujiya","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopaedic Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjiv","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Arya","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"R1-20260922","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1016\/j.ejca.2006.05.015","article-title":"Bone tumours in European children and adolescents, 1978-1997. 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