Screening for anxiety and depression in cancer patients: the effects of disease and treatment

Ibbotson, T.; Maguire, Peter; Selby, Peter J.; Priestman, T. J.; Wallace, LM

doi:10.1016/s0959-8049(05)80015-2

Cited by 393 publications

(302 citation statements)

References 12 publications

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“…This cutoff score was reported by Ibbotson et al (1994) to be the best for identifying patients likely to have an interview based diagnosis of depressive or anxiety disorder. The reliability, validity and factor structure of the HADS has been established in a variety of clinical populations (Moorey et al, 1991;Johnston et al, 2000;Mykletun et al, 2001;Smith et al, 2002) and validated in this population of cancer patients.…”

Section: Methodsmentioning

confidence: 99%

“…A diagnostic interview that interrogated patients about the timing of symptoms would be expected to produce a lower prevalence estimate of cases. There has also been some controversy about the validity of the HADS at the recommended cutoff scores in detecting distress in patients with all cancer types and at all disease stages (Ibbotson et al, 1994;Hall et al, 1999). The scores we used were based on the best available data and on our own validation study.…”

Section: Limitationsmentioning

confidence: 99%

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Emotional distress in cancer patients: the Edinburgh Cancer Centre symptom study

et al. 2007

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To: (1) estimate the prevalence of clinically significant emotional distress in patients attending a cancer outpatient department and (2) determine the associations between distress and demographic and clinical variables, we conducted a survey of outpatients attending selected clinics of a regional cancer centre in Edinburgh, UK. Patients completed the Hospital Anxiety and Depression Scale (HADS) on touch-screen computers and the scores were linked to clinical variables on the hospital database. Nearly one quarter of the cancer outpatients 674 out of 3071 (22%; 95% confidence interval (CI) 20 -23%) met our criterion for clinically significant emotional distress (total HADS score 15 or more). Univariate analysis identified the following statistically significant associations: age o65, female gender, cancer type and extent of disease. Multivariate analysis indicated that age o65 (odds ratio 1.41; 95% CI 1.18 -1.69), female gender (odds ratio 1.58; 95% CI 1.31 -1.92) and active disease (odds ratio 1.72; 95% CI 1.43 -2.05) but not cancer diagnosis, were the independent predictors of clinically significant emotional distress. Services to treat distress in cancer patients should be organised to target patients by characteristics other than their cancer diagnosis.

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Section: Methodsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Emotional distress in cancer patients: the Edinburgh Cancer Centre symptom study

et al. 2007

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“…Although psychometrically tested in other settings (Foot and Sanson-Fisher, 1995;Hopwood et al 1991;Ibbotson et al 1994;Moorey et al 1991), the validity and reliability of patients' responses to the HADS and CNQ questions using a touchscreen computer survey is unknown. However, another study is currently underway to explore this issue and results from computerised surveys in general practice have been found to closely reflect the results from identical pen and paper surveys (Bonevski, 1996).…”

Section: Strengths Limitations and Future Directionsmentioning

confidence: 99%

The physical and psycho-social experiences of patients attending an outpatient medical oncology department: a cross-sectional study

Newell

Sanson‐Fisher

Girgis

et al. 1999

European Journal of Cancer Care

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The aim of this study was to assess the prevalence and predictors of physical symptoms, anxiety, depression and perceived needs among patients receiving treatment at an outpatient medical oncology department using a cross‐sectional survey. It was carried out at the outpatient clinic of an academic medical oncology department, which sees around 150–180 outpatients each week; 201 patients were selected. These patients answered questions to assess their levels of anxiety and depression (Hospital Anxiety and Depression Scale), perceived needs (Cancer Needs Questionnaire)and the frequency and severity of 15 physical symptoms. Fatigue, nausea, appetite loss and vomiting were the most commonly experienced and most debilitating physical symptoms. Approximately 25% of participants had borderline or clinical levels of anxiety and depression. Although relatively low levels of perceived needs were reported, physical and psychological needs were the most common. Levels of each outcome measure tended to be predictive of each other. Medical oncology outpatients experience a wide range of physical and psycho‐social problems which appear, to some extent, interrelated.

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“…Validation studies of the HADS against a standard psychiatric interview in homogeneous samples of breast cancer (Razavi et al, 1990;Hopwood et al, 1991a, b;Ramirez et al, 1995;Hall et al, 1999) or lymphoma (Razavi et al, 1992) patients have reported equivocal results about its screening performance. In a heterogeneous sample Ibbotson et al (1994) recommended different cut-off scores for optimal case identification for patients with Validating automated screening for psychological distress by means of computer touchscreens for use in routine oncology practice different disease or treatment characteristics, i.e. disease-free, stable or progressive disease; on or off treatment.…”

mentioning

confidence: 99%

Validating automated screening for psychological distress by means of computer touchscreens for use in routine oncology practice

et al. 2001

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SummaryThe aim of the study was to confirm the validity of using touchscreen computers for screening for clinically significant levels of distress among cancer patients in routine oncology practice. The Hospital Anxiety and Depression Scale (HADS), EORTC Quality of Life questionnaire (QLQ-C30), Mental Health Inventory-MHI5 and a Concerns Checklist were administered via touchscreen computer to 172 chemotherapy out-patients, twice, 2-4 weeks apart. A standard psychiatric interview (Present State Examination -PSE) was conducted within a week of the second assessment. On interview, 23% of patients were identified as 'cases'. Using the available data (questionnaires, sociodemographic details, self-reported past psychiatric history), the best screening strategy combined scores from MHI-5 and HADS from a single time-point with the following rules: if MHI-5 < 11 = non-case; if MHI-5 ≥ 11 then use HADS; then, if HADS ≥ 9 = 'case' (sensitivity 85%; specificity 71%; misclassification rate 26%; positive predictive value 47%). The computerized screening system enabled data to be collected, scored, collated and reported in real time to identify patients who warrant further clinical assessment. It offers the potential for improving 'case' detection in routine oncology practice while reducing the burden of questions put to 'non-cases'. Further work is needed to develop optimal choice of screening questions for this purpose.

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Screening for anxiety and depression in cancer patients: the effects of disease and treatment

Cited by 393 publications

References 12 publications

Emotional distress in cancer patients: the Edinburgh Cancer Centre symptom study

Emotional distress in cancer patients: the Edinburgh Cancer Centre symptom study

The physical and psycho-social experiences of patients attending an outpatient medical oncology department: a cross-sectional study

Validating automated screening for psychological distress by means of computer touchscreens for use in routine oncology practice

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