Screening for psychiatric morbidity in patients with advanced breast cancer: validation of two self-report questionnaires

Abstract

Eighty-one patients with advanced breast cancer completed the Hospital Anxiety and Depression Scale (HADS) and Rotterdam Symptom Checklist (RSCL) to determine how well these questionnaires identified patients suffering from an anxiety state or depressive illness, compared with an independent interview by a psychiatrist who used the Clinical Interview Schedule. A threshold score was defined for each questionnaire which gave the optimal sensitivity and specificity. Seventy-five per cent of patients were correctly identified as suffering from an affective disorder by both the Rotterdam Symptom Checklist and by the Hospital Anxiety and Depression Scale. Twenty-one per cent of 'normal' patients were misclassified by the Rotterdam Checklist and 26% by the Hospital Anxiety and Depression Scale. When the HADs anxiety and depression subscales were analysed separately, the performance of the anxiety items was superior to that of the depression items. Both questionnaires were found to have good predictive value and could be used in patients with advanced cancer to help screen out those with an affective disorder.

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

“…Our findings of 24% of patients classified as having borderline or clinical anxiety and 23% with borderline or clinical depression are fairly consistent with the results of a previous study using the HADS with outpatients (Carroll et al 1993) but somewhat lower than the other previous studies, which have involved inpatients or only those with advanced disease (Carroll et al 1993;Hopwood et al 1991;Payne, 1989).…”

“…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).…”

Daily omega-3 fatty acid intake and depression in Japanese patients with newly diagnosed lung cancer

“…Fifth, we did not use a structured psychiatric interview in this study (such as the Structured Clinical Interview for DSM-IV, a widely recognized standard). However, HADS has been shown to be reliable and valid for the screening of depression in patients with cancer (Razavi et al, 1990;Hopwood et al, 1991), and is widely used in the field of oncology (Patrick et al, 2003). Finally, a causal relationship between o-3 FA intake and depression cannot be confirmed, because of the cross-sectional design of this study.…”

“…The HADS has been used as a reliable and valid method of screening for depression in patients with cancer (Razavi et al, 1990;Hopwood et al, 1991;Patrick et al, 2003). Each item is rated on a scale of 0 -3, with higher scores denoting a greater mood disturbance.…”

Psychiatric morbidity and its recognition by doctors in patients with cancer

“…Although the recognition of psychological morbidity is often hampered by the unwillingness of patients to disclose emotional concerns, the doctors are frequently reluctant to probe these areas satisfactorily (Hardman et al, 1989;Hopwood et al, 1991;Ford et al, 1996). For example in one study in which oncologists were tape-recorded giving patients bad news about their diagnoses and prognoses, the levels of psychological probing were low.…”