Screening for Major Depression in Cancer Outpatients

نویسندگان

  • Jane Walker
  • Isabella Butcher
  • Laura Hodges
  • Annet Kleiboer
  • Mark O’Connor
  • MBChB
  • Lucy Wall
  • Kurt Kroenke
  • Michael Sharpe
چکیده

BACKGROUND: Systematic screening for depression has been recommended for patients who have medical conditions like cancer. The 9-item Patient Health Questionnaire (PHQ-9) is becoming widely used, but its diagnostic accuracy has not yet been tested in a cancer patient population. In this article, the authors report on the performance of the PHQ-9 as a screening instrument for major depressive disorder (MDD) in patients with cancer. METHODS: Data obtained from a depression screening service for patients who were attending clinics of a Regional Cancer Centre in Edinburgh, United Kingdom were used. Patients had completed both the PHQ-9 and a 2-stage procedure to identify cases of MDD. Performance of the PHQ-9 in identifying cases of MDD was determined using receiver operating characteristic (ROC) analysis. RESULTS: Data were available on 4264 patients. When scored as a continuous measure, the PHQ-9 performed well with an area under the ROC curve of 0.94 (95% confidence interval [CI], 0.93-0.95). A cutoff score of 8 provided a sensitivity of 93% (95% CI, 89%-95%), a specificity of 81% (95% CI, 80%-82%), a positive predictive value (PPV) of 25%, and a negative predictive value (NPV) of 99% and could be considered optimum in a screening context. The PHQ-9 did not perform as well when it was scored using an algorithm with a sensitivity of 56% (95% CI, 55%-57%), a specificity of 96% (95% CI, 95%-97%), a PPV of 52%, and an NPV of 97%. CONCLUSIONS: The PHQ-9 scored as a continuous measure with a cutoff score of 8 performed well in identifying MDD in cancer patients and should be considered as a screening instrument in this population. Cancer 2011;117:218–27. VC 2010 American Cancer Society.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Evaluation of Distress and Stress in Cancer Patients in AMIR Oncology Hospital in Shiraz

Background Routine screening for distress is internationally recommended as a necessary standard for good cancer care given its high prevalence and negative consequences on quality of life. This study attempts to support validation of Distress Thermometer (DT) in Shiraz, Iran and in the second step to investigate privilege/priority of DT over other referent criterion measures. Material and m...

متن کامل

Recognition of Depression and Anxiety among Elderly Colorectal Cancer Patients

This study investigated the ICD-9 diagnostic rates of depressive and anxiety disorders, including major depression, neurotic depression, adjustment disorder with depressed mood, depressive disorder NOS (not elsewhere classified), and anxiety states, among elderly Medicare beneficiaries (age ≥ 65) who received a colorectal cancer diagnosis between 1998 and 2002 in U.S. The Seer-Medicare data, re...

متن کامل

[Validation of geriatric depression scale in a general outpatient clinic].

OBJECTIVE The Geriatric Depression Scale for screening depressive symptoms in the elderly has not been assessed in elderly outpatients who seek primary health care in Brazil. The objective was to determine the validity of the Short Scale for Major Depressive Episode or Dysthymia (GDS-15) in elderly outpatients. METHODS The scale was applied in 302 subjects with 65 years and older and then exa...

متن کامل

Thoughts of death and suicide reported by cancer patients who endorsed the "suicidal thoughts" item of the PHQ-9 during routine screening for depression.

BACKGROUND Patients with serious medical illnesses, such as cancer, are at increased risk of suicide but are also often facing death. The Patient Health Questionnaire-9 (PHQ-9) is widely used to screen patients for depression. It includes an item that asks about thoughts of death and hurting yourself (Item-9). OBJECTIVE To describe the nature of thoughts of death and suicide reported in clini...

متن کامل

Screening for depression in patients with coronary heart disease (data from the Heart and Soul Study).

Major depression is associated with adverse outcomes in patients who have coronary heart disease. How best to identify depression in busy cardiology practices is unknown. We compared the test characteristics of 4 depression screening instruments with an interview diagnosis of depression (Diagnostic Interview Schedule) in 1,024 outpatients who had coronary heart disease. Screening instruments we...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره   شماره 

صفحات  -

تاریخ انتشار 2010