While efforts at studying psychological distress in cancer date as far back as the 1980s (Derogatis et al., 1983), results from research groups worldwide revealed widely varying prevalence rates. For example, the frequency of depressive symptoms ranged from as low as 4.5% (Lansky et al., 1985) to as high as over 50% (Craig and Abeloff, 1974). Such discrepant estimates are due to varying conceptualizations of depression, differences in methodology used, and diverse populations studied (Trask, 2004). Of particular concern is the use of screening instruments that are of limited diagnostic reliability.