Christopher J Recklitis1,2, Jaime E Blackmon1, Grace Chang3,4. 1. Dana-Farber Cancer Institute, Perini Family Survivors' Center, Boston, Massachusetts. 2. Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. 3. Department of Psychiatry, VA Boston Healthcare System, Brockton, Massachusetts. 4. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Abstract
BACKGROUND: The validity of the Distress Thermometer (DT) as a screen for psychological distress in young adult cancer survivors was assessed by comparing it with the results of a psychiatric diagnostic interview, the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (SCID), to evaluate the accuracy of the DT and identify optimal cutoff scores for this population. METHODS: A total of 247 survivors aged 18 to 40 years completed the DT and SCID. Based on the SCID, participants were classified as having: 1) ≥ 1 SCID diagnoses; 2) significant symptoms, but no SCID diagnosis; or 3) no significant SCID symptoms. Receiver operating characteristic analyses determined the sensitivity and specificity of all possible DT cutoff scores for detecting survivors with a SCID diagnosis, and subsequently for survivors with significant SCID symptoms or a SCID diagnosis. RESULTS: The recommended DT cutoff score of ≥5 failed to identify 31.81% of survivors with a SCID diagnosis (sensitivity of 68.18% and specificity of 78.33%), and 32.81% of survivors with either significant SCID symptoms or a SCID diagnosis. No alternative DT cutoff score met the criteria for acceptable sensitivity (≥85%) and specificity (≥75%). CONCLUSIONS: The DT does not reliably identify young adult cancer survivors with psychiatric problems identified by a "gold standard" structured psychiatric interview. Therefore, the DT should not be used as a stand-alone psychological screen in this population. Cancer 2016;122:296-303.
BACKGROUND: The validity of the Distress Thermometer (DT) as a screen for psychological distress in young adult cancer survivors was assessed by comparing it with the results of a psychiatric diagnostic interview, the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (SCID), to evaluate the accuracy of the DT and identify optimal cutoff scores for this population. METHODS: A total of 247 survivors aged 18 to 40 years completed the DT and SCID. Based on the SCID, participants were classified as having: 1) ≥ 1 SCID diagnoses; 2) significant symptoms, but no SCID diagnosis; or 3) no significant SCID symptoms. Receiver operating characteristic analyses determined the sensitivity and specificity of all possible DT cutoff scores for detecting survivors with a SCID diagnosis, and subsequently for survivors with significant SCID symptoms or a SCID diagnosis. RESULTS: The recommended DT cutoff score of ≥5 failed to identify 31.81% of survivors with a SCID diagnosis (sensitivity of 68.18% and specificity of 78.33%), and 32.81% of survivors with either significant SCID symptoms or a SCID diagnosis. No alternative DT cutoff score met the criteria for acceptable sensitivity (≥85%) and specificity (≥75%). CONCLUSIONS: The DT does not reliably identify young adult cancer survivors with psychiatric problems identified by a "gold standard" structured psychiatric interview. Therefore, the DT should not be used as a stand-alone psychological screen in this population. Cancer 2016;122:296-303.
Keywords:
4th Edition (SCID); Distress Thermometer; Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders; anxiety; cancer survivors; depression; validation
Authors: Lonnie K Zeltzer; Christopher Recklitis; David Buchbinder; Bradley Zebrack; Jacqueline Casillas; Jennie C I Tsao; Qian Lu; Kevin Krull Journal: J Clin Oncol Date: 2009-03-02 Impact factor: 44.544
Authors: John W Williams; Michael Pignone; Gilbert Ramirez; Christina Perez Stellato Journal: Gen Hosp Psychiatry Date: 2002 Jul-Aug Impact factor: 3.238
Authors: Bernd Löwe; Kerstin Gräfe; Stephan Zipfel; Robert L Spitzer; Christoph Herrmann-Lingen; Steffen Witte; Wolfgang Herzog Journal: J Psychosom Res Date: 2003-12 Impact factor: 3.006
Authors: Abby R Rosenberg; Miranda C Bradford; Kira Bona; Michele L Shaffer; Joanne Wolfe; K Scott Baker; Nancy Lau; Joyce Yi-Frazier Journal: J Psychosoc Oncol Date: 2017-11-03
Authors: Crystal S Denlinger; Jennifer A Ligibel; Madhuri Are; K Scott Baker; Gregory Broderick; Wendy Demark-Wahnefried; Debra L Friedman; Mindy Goldman; Lee W Jones; Allison King; Grace H Ku; Elizabeth Kvale; Terry S Langbaum; Mary S McCabe; Michelle Melisko; Jose G Montoya; Kathi Mooney; Mary Ann Morgan; Javid J Moslehi; Tracey O'Connor; Linda Overholser; Electra D Paskett; Jeffrey Peppercorn; M Alma Rodriguez; Kathryn J Ruddy; Tara Sanft; Paula Silverman; Sophia Smith; Karen L Syrjala; Susan G Urba; Mark T Wakabayashi; Phyllis Zee; Nicole R McMillian; Deborah A Freedman-Cass Journal: J Natl Compr Canc Netw Date: 2016-06 Impact factor: 11.908