Tim J Hartung1, Michael Friedrich1, Christoffer Johansen1,2,3, Hans-Ulrich Wittchen4, Herman Faller5, Uwe Koch6, Elmar Brähler7, Martin Härter8, Monika Keller9, Holger Schulz8, Karl Wegscheider10, Joachim Weis11, Anja Mehnert1. 1. Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany. 2. Oncology Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 3. Unit of Survivorship, The Danish Cancer Society Research Center, Copenhagen, Denmark. 4. Institute of Clinical Psychology and Psychotherapy, Dresden Technical University, Dresden, Germany. 5. Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center, Mainfranken University of Wurzburg, Wurzburg, Germany. 6. Deanery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 7. Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Mainz, Germany. 8. Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 9. Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine, University Hospital Heidelberg, Heidelberg, Germany. 10. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 11. Department of Psychooncology, UKF Reha gGmbH, University Clinic Center Freiburg, Freiburg, Germany.
Abstract
BACKGROUND: Depression screening in patients with cancer is recommended by major clinical guidelines, although the evidence on individual screening tools is limited for this population. Here, the authors assess and compare the diagnostic accuracy of 2 established screening instruments: the depression modules of the 9-item Patient Health Questionnaire (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS-D), in a representative sample of patients with cancer. METHODS: This multicenter study was conducted with a proportional, stratified, random sample of 2141 patients with cancer across all major tumor sites and treatment settings. The PHQ-9 and HADS-D were assessed and compared in terms of diagnostic accuracy and receiver operating characteristic (ROC) curves for Diagnostic and Statistical Manual of Mental Disorders, 4th edition diagnosis of major depressive disorder using the Composite International Diagnostic Interview for Oncology as the criterion standard. RESULTS: The diagnostic accuracy of the PHQ-9 and HADS-D was fair for diagnosing major depressive disorder, with areas under the ROC curves of 0.78 (95% confidence interval, 0.76-0.79) and 0.75 (95% confidence interval, 0.74-0.77), respectively. The 2 questionnaires did not differ significantly in their areas under the ROC curves (P = .15). The PHQ-9 with a cutoff score ≥7 had the best screening performance, with a sensitivity of 83% (95% confidence interval, 78%-89%) and a specificity of 61% (95% confidence interval, 59%-63%). The American Society of Clinical Oncology guideline screening algorithm had a sensitivity of 44% (95% confidence interval, 36%-51%) and a specificity of 84% (95% confidence interval, 83%-85%). CONCLUSIONS: In patients with cancer, the screening performance of both the PHQ-9 and the HADS-D was limited compared with a standardized diagnostic interview. Costs and benefits of routinely screening all patients with cancer should be weighed carefully. Cancer 2017;123:4236-4243.
BACKGROUND:Depression screening in patients with cancer is recommended by major clinical guidelines, although the evidence on individual screening tools is limited for this population. Here, the authors assess and compare the diagnostic accuracy of 2 established screening instruments: the depression modules of the 9-item Patient Health Questionnaire (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS-D), in a representative sample of patients with cancer. METHODS: This multicenter study was conducted with a proportional, stratified, random sample of 2141 patients with cancer across all major tumor sites and treatment settings. The PHQ-9 and HADS-D were assessed and compared in terms of diagnostic accuracy and receiver operating characteristic (ROC) curves for Diagnostic and Statistical Manual of Mental Disorders, 4th edition diagnosis of major depressive disorder using the Composite International Diagnostic Interview for Oncology as the criterion standard. RESULTS: The diagnostic accuracy of the PHQ-9 and HADS-D was fair for diagnosing major depressive disorder, with areas under the ROC curves of 0.78 (95% confidence interval, 0.76-0.79) and 0.75 (95% confidence interval, 0.74-0.77), respectively. The 2 questionnaires did not differ significantly in their areas under the ROC curves (P = .15). The PHQ-9 with a cutoff score ≥7 had the best screening performance, with a sensitivity of 83% (95% confidence interval, 78%-89%) and a specificity of 61% (95% confidence interval, 59%-63%). The American Society of Clinical Oncology guideline screening algorithm had a sensitivity of 44% (95% confidence interval, 36%-51%) and a specificity of 84% (95% confidence interval, 83%-85%). CONCLUSIONS: In patients with cancer, the screening performance of both the PHQ-9 and the HADS-D was limited compared with a standardized diagnostic interview. Costs and benefits of routinely screening all patients with cancer should be weighed carefully. Cancer 2017;123:4236-4243.
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: M Bossart; H Plett; B Krämer; E Braicu; B Czogalla; M Klar; S Singer; D Mayr; A Staebler; A du Bois; S Kommoss; T Link; A Burges; F Heitz; M Grube; F Trillsch; P Harter; P Wimberger; P Buderath; A Hasenburg Journal: Arch Gynecol Obstet Date: 2022-09-21 Impact factor: 2.493
Authors: Hamad S Alyami; Abdallah Y Naser; Eman Zmaily Dahmash; Mohammed H Alyami; Musfer S Alyami Journal: Int J Clin Pract Date: 2021-04-27 Impact factor: 3.149
Authors: Patricia A Ganz; Julienne E Bower; Ann H Partridge; Antonio C Wolff; Elissa D Thorner; Hadine Joffe; Michael R Irwin; Laura Petersen; Catherine M Crespi Journal: JNCI Cancer Spectr Date: 2021-02-08
Authors: Johanna T W Snijkers; Wendy van den Oever; Zsa Zsa R M Weerts; Lisa Vork; Zlatan Mujagic; Carsten Leue; Martine A M Hesselink; Joanna W Kruimel; Jean W M Muris; Roel M M Bogie; Ad A M Masclee; Daisy M A E Jonkers; Daniel Keszthelyi Journal: Neurogastroenterol Motil Date: 2021-05-03 Impact factor: 3.960