Identifying tumor patients' depression
The aim of this study was to compare the precision of two different methods in detecting clinical depression in tumor patients: the use of a screening questionnaire versus the assessment by health care providers (nurses and doctors).
During their first days of inpatient cancer treatment, tumor patients were interviewed using the Structured Clinical Interview for DSM (SCID). Their physicians and nurses were asked to assess the mental health of the patients and their need for professional psychosocial support. Additionally, every patient completed the Hospital Anxiety and Depression Scale (HADS).
Out of 329 patients, 28 were diagnosed with either a major or a minor depression according to the SCID. Physicians assessed 15 of the depressed patients as being depressed (sensitivity, 0.54; specificity, 0.38). Nurses identified 19 (sensitivity, 0.68; specificity, 0.45) and the HADS 27 (sensitivity, 0.96; specificity, 0.50) of the depressed patients.
The HADS performed well in detecting depressed cancer patients in acute oncological care, whereas physicians and nurses often were unable to recognize depressed patients.
KeywordsCancer Depression Delivery of healthcare Distress Mental health Screening
This study was funded by the German Federal Ministry of Education and Research (grant #01ZZ0106). We would like to acknowledge the time and effort all the patients, physicians, and nurses have put into this study; we are deeply grateful to them. Important contributions to this study were also provided by the other study group members Oliver Krauß, Matthias Kauschke, and Heike Slesazeck. We would like to dedicate this article to Prof. Reinhold Schwarz who had initiated and supervised this study and for whom the well-being of cancer patients and their relatives was of utmost importance throughout his career.
Conflict of interest
The authors declare that there are no conflicts of interest.
- 7.Pasquini M, Biondi M, Costantini A, Cairoli F, Ferrarese G, Picardi A, Sternberg C (2006) Detection and treatment of depressive and anxiety disorders among cancer patients: feasibility and preliminary findings from a liaison service in an oncology division. Depress Anxiety 23:441–448PubMedCrossRefGoogle Scholar
- 20.Akechi T, Okuyama T, Onishi J, Morita T, Furukawa TA (2008) Psychotherapy for depression among incurable cancer patients. Cochrane Database Syst Rev (2):CD005537Google Scholar
- 25.First M, Spitzer R, Gibbon M, Williams J (1997) Structured clinical interview for DSM-IV Axis I disorders (SCID-I), clinician version. American Psychiatric Press, WashingtonGoogle Scholar
- 26.Wittchen H-U, Zaudig M, Fydrich T (1997) SKID-Strukturiertes Klinisches Interview für DSM-IV. Hogrefe-Verlag, GöttingenGoogle Scholar
- 30.Herrmann C, Buss U, Snaith RP (1995) HADS-D: Hospital Anxiety and Depression Scale. Huber, Bern (Ein Fragebogen zur Erfassung von Angst und Depressivität in der somatischen Medizin [Deutsche version])Google Scholar
- 31.StataCorp (2007) Stata Statistical Software: release 10. StataCorp LP, College StationGoogle Scholar
- 34.Classen CC, Kraemer HC, Blasey C, Giese-Davis J, Koopman C, Palesh OG, Atkinson A, Dimiceli S, Stonisch-Riggs G, Westendorp J, Morrow GR, Spiegel D (2008) Supportive-expressive group therapy for primary breast cancer patients: a randomized prospective multicenter trial. Psychooncology 17:438–447PubMedCrossRefGoogle Scholar