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Screening for Adjustment Disorders and Major Depressive Disorders in Cancer In-Patients

Published online by Cambridge University Press:  02 January 2018

Darius Razavi*
Affiliation:
Service de Médecine et Laboratoire d'Investigation Clinique H. J. Tagnon, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles
Nicole Delvaux
Affiliation:
CAM, Groupe de Recherche et de Formation
Christine Farvacques
Affiliation:
CAM, Groupe de Recherche et de Formation
Edmond Robaye
Affiliation:
Université Libre de Bruxelles, Faculté des Sciences Psychologiques et Pédagogiques
*
rue Héger Bordet I, 1000 Bruxelles, Belgium

Abstract

The Hospital Anxiety and Depression Scale (HADS), a four-point, 14-item questionnaire, was tested as a screening method for adjustment disorders and major depressive disorders in a sample of 210 cancer in-patients. A receiver operating characteristic (ROC) analysis was performed, giving the relationship between the true positive rate (sensitivity) and the false positive rate (1 – specificity). This makes it possible to choose an optimal cut-off point that takes into account the costs and benefits of treatment of psychological distress. For screening for major depressive disorders only, a cut-off score of 19 gave 70% sensitivity and 75% specificity. For screening for adjustment disorders and major depressive disorders taken together, a cut-off score of 13 gave 75% sensitivity and 75% specificity. HADS appears in this study to be a simple, sensitive and specific tool for screening for psychiatric disorders in an oncology in-patient population.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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References

American Psychiatric Association, Committee On Nomenclature And Statistics (1980) Diagnostic and Statistical Manual of Mental Disorders. Washington DC: American Psychiatric Association. Translated (1983) as DSM–III: Manuel Diagnostique et Statistique des Troubles Mentaux , by Pichot, P. & Guelfi, J. D. Paris: Masson.Google Scholar
Aylard, P. R., Gooding, J. H., McKenna, P. J., et al (1987) A validation study of three anxiety and depression self-assessment scales. Journal of Psychosomatic Research, 31, 261268.CrossRefGoogle ScholarPubMed
Derogatis, L. R., Abeloff, M. D. & McBeth, C. D. (1976) Cancer patients and their physicians in the perception of psychological symptoms. Psychosomatics, 17, 197201.CrossRefGoogle ScholarPubMed
Derogatis, L. R., Morrow, G. R. & Fetting, J. (1983) The prevalence of psychiatric disorders among cancer patients. Journal of the American Medical Association, 249, 751757.CrossRefGoogle ScholarPubMed
Endicott, J. (1984) Measurement of depression in patients with cancer. Cancer (suppl.) 53, 22432250.CrossRefGoogle ScholarPubMed
Erdreich, L. S. & Lee, E. T. (1981) Use of relative operating characteristic analysis in epidemiology. American Journal of Epidemiology, 114, 649662.CrossRefGoogle ScholarPubMed
Fabrega, H. & Mezzich, J. (1987) Adjustment disorder and psychiatric practice: cultural and historical aspects. Psychiatry, 50, 3148.CrossRefGoogle ScholarPubMed
Faverge, J. M. (1954) Méthodes Statistiques en Psychologie Appliquée, Vol. II. Paris: PUF.Google Scholar
Feinstein, A. R. (1985) Diagnostic and spectral markers. In Clinical Epidemiology: the Architecture of Clinical Research. Philadelphia: W. B. Saunders.Google Scholar
Hamilton, M. (1959) The assessment of anxiety states by rating. British Journal of Psychiatry, 32, 5055.Google ScholarPubMed
Karnofsky, D. A. & Burcheval, J. H. (1949) The clinical evaluation of chemotherapeutic agents in cancer. In Evaluation of Chemotherapeutic Agents (ed. C. M. McLeod). New York: Colombia University Press.Google Scholar
Lepine, J. P., Godechau, M., Brun, P., et al (1985) Evaluation de l'anxiété et de la dépression chez des patients hospitalises dans un service de médecine interne. Annales Médico-Psychologiques, 2, 175189.Google Scholar
Mari, J. J. & Williams, P. (1985) A comparison of the validity of two psychiatric screening questionnaires (GHQ–12 and SRQ–20) in Brazil using Relative Operating Characteristic (ROC) analysis. Psychological Medicine. 15, 651659.CrossRefGoogle ScholarPubMed
Metz, C. E. (1978) Basic principles of ROC analysis. Seminaire of Nuclear Medicine, 8, 283298.CrossRefGoogle ScholarPubMed
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382389.CrossRefGoogle ScholarPubMed
Murphy, J. M., Berwick, D. M., Weinstein, M. C., et al (1987) Performance of screening and diagnostic tests: application of receiver operating characteristic analysis. Archives of General Psychiatry, 44, 550555.CrossRefGoogle ScholarPubMed
Razavi, D., Delvaux, N., Farvacques, C., et al (1989) Validation de la version française du HADS dans une population de patients cancéreux hospitalisés. Revue de Psychologie Appliquée (in press).Google Scholar
Spitzer, R. L. (1983) Structured Clinical Interview for DSM–III. New York: New York State Institute.Google Scholar
Swets, J. A. (1986) Indices of discrimination or diagnostic accuracy: their ROCS and implied models. Psychological Bulletin, 99, 100117.CrossRefGoogle ScholarPubMed
Tarnopolsky, A., Hand, D. J., McLean, E. K., et al (1979) Validity and uses of a screening questionnaire (GHQ) in the community. British Journal of Psychiatry, 134, 508515.CrossRefGoogle ScholarPubMed
Zigmond, A. S. & Snaith, R. P. (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361370.CrossRefGoogle ScholarPubMed
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