Karen L Weihs1,2, Joshua F Wiley3, Catherine M Crespi4,5, Jennifer L Krull4, Annette L Stanton4,6,7. 1. Department of Psychiatry, University of Arizona, Tucson, Arizona, USA. 2. University of Arizona Cancer Center, Tucson, Arizona, USA. 3. School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia. 4. Department of Psychology, University of California, Los Angeles, California, USA. 5. Department of Biostatistics, University of California, Los Angeles, California, USA. 6. Departments of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA. 7. Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, USA.
Abstract
OBJECTIVE: Create a brief, self-report screener for recently diagnosed breast cancer patients to identify patients at risk of future depression. METHODS: Breast cancer patients (N = 410) within 2 ± 1 months after diagnosis provided data on depression vulnerability. Depression outcomes were defined as a high depressive symptom trajectory or a major depressive episode during 16 months after diagnosis. Stochastic gradient boosting of regression trees identified 7 items highly predictive for the depression outcomes from a pool of 219 candidate depression vulnerability items. Three of the 7 items were from the Patient Health Questionnaire 4 (PHQ-4), a validated screener for current anxiety/depressive disorder that has not been tested to identify risk for future depression. Thresholds classifying patients as high or low risk on the new Depression Risk Questionnaire 7 (DRQ-7) and the PHQ-4 were obtained. Predictive performance of the DRQ-7 and PHQ-4 was assessed on a holdout validation subsample. FINDINGS: DRQ-7 items assess loneliness, irritability, persistent sadness, and low acceptance of emotion as well as 3 items from the PHQ-4 (anhedonia, depressed mood, and worry). A DRQ-7 score of ≥6/23 identified depression outcomes with 0.73 specificity, 0.83 sensitivity, 0.68 positive predictive value, and 0.86 negative predictive value. A PHQ-4 score of ≥3/12 performed moderately well but less accurately than the DRQ-7 (net reclassification improvement = 10%; 95% CI [0.5-16]). INTERPRETATION: The DRQ-7 and the PHQ-4 with a new cutoff score are clinically accessible screeners for risk of depression in newly diagnosed breast cancer patients. Use of the screener to select patients for preventive interventions awaits validation of the screener in other samples.
OBJECTIVE: Create a brief, self-report screener for recently diagnosed breast cancerpatients to identify patients at risk of future depression. METHODS:Breast cancerpatients (N = 410) within 2 ± 1 months after diagnosis provided data on depression vulnerability. Depression outcomes were defined as a high depressive symptom trajectory or a major depressive episode during 16 months after diagnosis. Stochastic gradient boosting of regression trees identified 7 items highly predictive for the depression outcomes from a pool of 219 candidate depression vulnerability items. Three of the 7 items were from the Patient Health Questionnaire 4 (PHQ-4), a validated screener for current anxiety/depressive disorder that has not been tested to identify risk for future depression. Thresholds classifying patients as high or low risk on the new Depression Risk Questionnaire 7 (DRQ-7) and the PHQ-4 were obtained. Predictive performance of the DRQ-7 and PHQ-4 was assessed on a holdout validation subsample. FINDINGS:DRQ-7 items assess loneliness, irritability, persistent sadness, and low acceptance of emotion as well as 3 items from the PHQ-4 (anhedonia, depressed mood, and worry). A DRQ-7 score of ≥6/23 identified depression outcomes with 0.73 specificity, 0.83 sensitivity, 0.68 positive predictive value, and 0.86 negative predictive value. A PHQ-4 score of ≥3/12 performed moderately well but less accurately than the DRQ-7 (net reclassification improvement = 10%; 95% CI [0.5-16]). INTERPRETATION: The DRQ-7 and the PHQ-4 with a new cutoff score are clinically accessible screeners for risk of depression in newly diagnosed breast cancerpatients. Use of the screener to select patients for preventive interventions awaits validation of the screener in other samples.
Authors: John F Steiner; Tia A Cavender; Carolyn T Nowels; Brenda L Beaty; Cathy J Bradley; Diane L Fairclough; Deborah S Main Journal: Psychooncology Date: 2008-02 Impact factor: 3.894
Authors: Michael King; Carl Walker; Gus Levy; Christian Bottomley; Patrick Royston; Scott Weich; Juan Angel Bellón-Saameño; Berta Moreno; Igor Svab; Danica Rotar; J Rifel; Heidi-Ingrid Maaroos; Anu Aluoja; Ruth Kalda; Jan Neeleman; Mirjam I Geerlings; Miguel Xavier; Idalmiro Carraça; Manuel Gonçalves-Pereira; Benjamin Vicente; Sandra Saldivia; Roberto Melipillan; Francisco Torres-Gonzalez; Irwin Nazareth Journal: Arch Gen Psychiatry Date: 2008-12
Authors: Michael H Antoni; Susan K Lutgendorf; Steven W Cole; Firdaus S Dhabhar; Sandra E Sephton; Paige Green McDonald; Michael Stefanek; Anil K Sood Journal: Nat Rev Cancer Date: 2006-03 Impact factor: 60.716
Authors: Mirjam Renovanz; Sari Soebianto; Helena Tsakmaklis; Naureen Keric; Minou Nadji-Ohl; Manfred Beutel; Florian Ringel; Daniel Wollschläger; Anne-Katrin Hickmann Journal: Support Care Cancer Date: 2019-03-23 Impact factor: 3.603
Authors: Isabelle S Smith; Rebecca Wallace; Cornelia Wellecke; Marie-Abèle Bind; Karen L Weihs; Bei Bei; Joshua F Wiley Journal: JMIR Res Protoc Date: 2022-07-27
Authors: Jacqueline H J Kim; Emma E Bright; Timothy J Williamson; Jennifer L Krull; Karen L Weihs; Annette L Stanton Journal: J Behav Med Date: 2020-06-13