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Identifying tumor patients' depression

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Abstract

Purpose

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).

Methods

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).

Results

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.

Conclusion

The HADS performed well in detecting depressed cancer patients in acute oncological care, whereas physicians and nurses often were unable to recognize depressed patients.

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References

  1. Surbone A, Baider L, Weitzman TS, Brames MJ, Rittenberg CN, Johnson J (2009) Psychosocial care for patients and their families is integral to supportive care in cancer: MASCC position statement. Support Care Cancer. doi:10.1007/s00520-009-0693-4

    PubMed  Google Scholar 

  2. Atesci FC, Baltalarli B, Oguzhanoglu NK, Karadag F, Ozdel O, Karagoz N (2004) Psychiatric morbidity among cancer patients and awareness of illness. Support Care Cancer 12:161–167

    Article  PubMed  Google Scholar 

  3. Kelly BJ, Pelusi D, Burnett PC, Varghese FT (2004) The prevalence of psychiatric disorder and the wish to hasten death among terminally ill cancer patients. Palliat Support Care 2:163–169

    Article  PubMed  Google Scholar 

  4. Gil Moncayo FL, Costa RG, Perez FJ, Salamero M, Sanchez N, Sirgo A (2008) Adaptación psicológica y prevalencia de trastornos mentales en pacientes con cáncer. Med Clín 130:90–92

    Article  Google Scholar 

  5. Härter M, Reuter K, Schretzmann B, Hasenburg A, Aschenbrenner A, Weis J (2000) Komorbide psychische Störungen bei Krebspatienten in der stationären Akutbehandlung und medizinischen Rehabilitation. Rehabilitation 39:317–323

    Article  PubMed  Google Scholar 

  6. Iqbal A (2004) Common types of mental disorders in adult cancer patients seen at Shaukat Khanum Memorial Cancer Hospital and Research Centre. JAMC 16:65–69

    PubMed  Google Scholar 

  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 23:441–448

    Article  PubMed  CAS  Google Scholar 

  8. Sharpe M, Strong V, Allen K, Rush R, Postma K, Tulloh A, Maguire P, House A, Ramirez A, Cull A (2004) Major depression in outpatients attending a regional cancer centre: screening and unmet treatment needs. Br J Cancer 90:314–320

    Article  PubMed  CAS  Google Scholar 

  9. Wancata J, Benda N, Windhaber J, Nowotny M (2001) Does psychiatric comorbidity increase the length of stay in general hospitals? Gen Hosp Psychiatry 23:8–14

    Article  PubMed  CAS  Google Scholar 

  10. Utne I, Miaskowski C, Bjordal K, Paul SM, Rustoen T (2010) The relationships between mood disturbances and pain, hope, and quality of life in hospitalized cancer patients with pain on regularly scheduled opioid analgesic. J Palliat Med 13:311–318

    Article  PubMed  Google Scholar 

  11. Antypa N, Van der Does AJW, Penninx BWJH (2010) Cognitive reactivity: investigation of a potentially treatable marker of suicide risk in depression. J Affect Disord 122:46–52

    Article  PubMed  Google Scholar 

  12. Akechi T, Okamura H, Kugaya A, Nakano T, Nakanishi T, Akizuki N, Yamawaki S, Uchitomi Y (2000) Suicidal ideation in cancer patients with major depression. Jpn J Clin Oncol 30:221–224

    Article  PubMed  CAS  Google Scholar 

  13. Van Orden KA, Witte TK, Cukrowicz KC, Braithwaite SR, Selby EA, Joiner TE (2010) The interpersonal theory of suicide. Psychol Rev 117:575–600

    Article  PubMed  Google Scholar 

  14. Davidson CL, Wingate LR, Rasmussen KA, Slish ML (2009) Hope as a predictor of interpersonal suicide risk. Suicide Life-Threat Behav 39:499–507

    Article  PubMed  Google Scholar 

  15. Sanatani M, Schreier G, Stitt L (2008) Level and direction of hope in cancer patients: an exploratory longitudinal study. Support Care Cancer 16:493–499

    Article  PubMed  Google Scholar 

  16. Krauß O, Ernst J, Kuchenbecker D, Hinz A, Schwarz R (2007) Prädiktoren psychischer Störungen bei Tumorpatienten: Empirische Befunde. PPmP 57:273–280

    PubMed  Google Scholar 

  17. Price A, Hotopf M (2009) The treatment of depression in patients with advanced cancer undergoing palliative care. Curr Opin Support Palliat Care 3:61–66

    Article  PubMed  Google Scholar 

  18. Naaman SC, Radwan K, Fergusson D, Johnson S (2009) Status of psychological trials in breast cancer patients: a report of three meta-analyses. Psychiatry 72:50–69

    Article  PubMed  Google Scholar 

  19. Rodin G, Lloyd N, Katz M, Green E, Mackay JA, Wong RK (2007) The treatment of depression in cancer patients: a systematic review. Support Care Cancer 15:123–136

    Article  PubMed  Google 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):CD005537

  21. Söllner W, DeVries A, Steixner E, Lukas P, Sprinzl G, Rumpold G, Maislinger S (2001) How successful are oncologists in identifying patient distress, perceived social support, and need for psychosocial counselling? Br J Cancer 84:179–185

    Article  PubMed  Google Scholar 

  22. Fallowfield L, Ratcliffe D, Jenkins V, Saul J (2001) Psychiatric morbidity and its recognition by doctors in patients with cancer. Br J Cancer 84:1011–1015

    Article  PubMed  CAS  Google Scholar 

  23. Newell S, Sanson-Fisher RW, Girgis A, Bonaventura A (1998) How well do medical oncologists' perceptions reflect their patients' reported physical and psychosocial problems? Data from a survey of five oncologists. Cancer 83:1640–1651

    Article  PubMed  CAS  Google Scholar 

  24. Keller M, Sommerfeldt S, Fischer C, Knight L, Riesbeck M, Lowe B, Herfarth C, Lehnert T (2004) Recognition of distress and psychiatric morbidity in cancer patients: a multi-method approach. Ann Oncol 15:1243–1249

    Article  PubMed  CAS  Google 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, Washington

    Google Scholar 

  26. Wittchen H-U, Zaudig M, Fydrich T (1997) SKID-Strukturiertes Klinisches Interview für DSM-IV. Hogrefe-Verlag, Göttingen

    Google Scholar 

  27. Segal DL, Hersen M, Van Hasselt VB (1994) Reliability of the structured clinical interview for DSM-III-R: an evaluative review. Compr Psychiatry 35:316–327

    Article  PubMed  CAS  Google Scholar 

  28. Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67:361–370

    Article  PubMed  CAS  Google Scholar 

  29. Singer S, Kuhnt S, Götze H, Hauss J, Hinz A, Liebmann A, Krauß O, Lehmann A, Schwarz R (2009) Hospital Anxiety and Depression Scale cut-off scores for cancer patients in acute care. Br J Cancer 100:908–912

    Article  PubMed  CAS  Google 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 Station

    Google Scholar 

  32. Passik SD, Dugan W, McDonald MV, Rosenfeld B, Theobald DE, Edgerton S (1998) Oncologists' recognition of depression in their patients with cancer. J Clin Oncol 16:1594–1600

    PubMed  CAS  Google Scholar 

  33. Pitceathly C, Maguire P, Fletcher I, Parle M, Tomenson B, Creed F (2009) Can a brief psychological intervention prevent anxiety or depressive disorders in cancer patients? A randomised controlled trial. Ann Oncol 20:928–934

    Article  PubMed  CAS  Google 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 17:438–447

    Article  PubMed  Google Scholar 

  35. Mitchell AJ, Kaar S, Coggan C, Herdman J (2008) Acceptability of common screening methods used to detect distress and related mood disorders-preferences of cancer specialists and non-specialists. Psychooncology 17:226–236

    Article  PubMed  Google Scholar 

  36. Jones LE, Doebbeling CC (2007) Suboptimal depression screening following cancer diagnosis. Gen Hosp Psychiatry 29:547–554

    Article  PubMed  Google Scholar 

  37. Alexandrowicz R, Weiss M, Marquart B, Wancata J (2008) The validity of a two-step-screening procedure for depression. Psychiatr Prax 35:294–301

    Article  PubMed  Google Scholar 

  38. Passik SD, Donaghy KB, Theobald DE, Lundberg JC, Holtsclaw E, Dugan J (2000) Oncology staff recognition of depressive symptoms on videotaped interviews of depressed cancer patients: implications for designing a training program. J Pain Symptom Manage 19:329–338

    Article  PubMed  CAS  Google Scholar 

  39. Fallowfield L, Lipkin M, Hall A (1998) Teaching senior oncologists communication skills: results from phase I of a comprehensive longitudinal program in the United Kingdom. J Clin Oncol 16:1961–1968

    PubMed  CAS  Google Scholar 

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Acknowledgements

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.

Author information

Authors and Affiliations

  1. Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany

    Susanne Singer, Andreas Hinz & Elmar Brähler

  2. Cancer Epidemiology Unit, University of Oxford, Oxford, UK

    Anna Brown

  3. Department of Obstetrics and Gynecology, University of Leipzig, Leipzig, Germany

    Jens Einenkel

  4. Department of Surgery, University of Leipzig, Leipzig, Germany

    Johann Hauss

  5. Department of Radio-Oncology, University of Leipzig, Leipzig, Germany

    Andrea Klein & Kirsten Papsdorf

  6. Department of Urology, University of Leipzig, Leipzig, Germany

    Jens-Uwe Stolzenburg

Authors
  1. Susanne Singer
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  4. Johann Hauss
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Correspondence to Susanne Singer.

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Singer, S., Brown, A., Einenkel, J. et al. Identifying tumor patients' depression. Support Care Cancer 19, 1697–1703 (2011). https://doi.org/10.1007/s00520-010-1004-9

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  • DOI: https://doi.org/10.1007/s00520-010-1004-9

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