Purpose This study examines the relationship between specific problem categories endorsed by patients with cancer seeking psycho-oncology services and their levels of distress and depression. Additionally, we investigate the potential associations between demographic and clinical characteristics and the endorsement of specific problem categories.

Methods A non-randomised interventional study was conducted with adult patients referred for psycho-oncology services. Patients attended 1–2 psycho-oncology sessions, completing the distress thermometer, problem checklist and Patient Health Questionnaire at the start of each visit and repeated the distress thermometer at visit end. Analyses evaluated the associations between problem checklist categories and levels of distress and depression.

Results Patients who endorsed a higher problem load, regardless of problem category, endorsed higher levels of distress and depression. Notably, younger patients, non-white patients and patients with breast cancer endorsed higher problem loads.

Conclusion The findings emphasise the importance of addressing problem load as a contributor to distress and depression among patients with cancer. While problem load was associated with patient characteristics, further investigation is needed to understand how these characteristics may influence distress and depression directly. Interventions should focus on reducing problem load to improve psychological well-being.