Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-05-11T03:18:02.534Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparing the distress thermometer (DT) with the patient health questionnaire (PHQ)-2 for screening for possible cases of depression among patients newly diagnosed with advanced cancer

Published online by Cambridge University Press:  13 November 2013

Mark Lazenby ,
Jane Dixon ,
Mei Bai  and
Ruth McCorkle
Mark Lazenby*
Affiliation:
Yale University School of Nursing, New Haven, Connecticut
Jane Dixon
Affiliation:
Yale University School of Nursing, New Haven, Connecticut
Mei Bai
Affiliation:
Yale University School of Nursing, New Haven, Connecticut
Ruth McCorkle
Affiliation:
Yale University School of Nursing, New Haven, Connecticut
*
Address correspondence and reprint requests to: Mark Lazenby, Yale University School of Nursing, New Haven, CT 06477. E-mail: mark.lazenby@yale.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Distress screening guidelines call for rapid screening for emotional distress at the time of cancer diagnosis. The purpose of this study was to examine the distress thermometer's (DT) ability to screen in patients in treatment for advanced cancer who may be depressed.

Methods:

Using cross-sectional data collected from patients within 30 days of diagnosis with advanced cancer, this study used ROC analysis to determine the optimal-cutoff point of the distress thermometer (DT) for screening for depression as measured by the physician health questionnaire (PHQ)-9; inter-test reliability analysis to compare the DT with the PHQ-2 for screening in possible cases of depression, and multivariate analysis to examine associations among the DT emotional problem list (EPL) items with cases of depression.

Results:

The average age of the 123 patients in the study was 59.9 (12.9) years. Seventy (56.9%) were female. All had Stage 3 or 4 cancers (40% gastrointestinal, 19% gynecologic, 20% head and neck, 21% lung). The mean DT score was 4 (2.7)/10; and 56 (43%) were depressed as measured by the PHQ-9 ≥5. The optimal DT cut-off score to screen in possible cases of depression was ≥2/10, with a sensitivity of .96, compared to a sensitivity of .32 of the PHQ-2 ≥2. Correlation coefficients for the DT ≥2 and the PHQ-2 with the PHQ-9 ≥5 were 0.4 and −0.2, respectively. EPL items associated with cases of depression were Depression (OR = 0.15, 0.02–0.85) and Sadness (OR = 0.21, 0.06–0.72).

Significance of Results:

The optimal DT threshold for identifying possible cases of depression at the time of diagnosis is ≥2; this threshold is more sensitive than the PHQ-2 ≥2. EPL items may be used with the DT score to triage patients for evaluation.

Keywords

DistressScreeningCancerDepressionDistress Thermometer
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 1 , February 2014 , pp. 63 - 68
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American College of Surgeons. (2012). Cancer program standards 2012, version 1.1: Ensuring patient-centered care. Retrieved February 4, 2013, from http://www.facs.org/cancer/coc/programstandards2012.htmlGoogle Scholar
Arroll, B., Goodyear-Smith, F., Crengle, S., Gunn, J., Kerse, N., Fishman, T., & Hatcher, S. (2010). Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Annals of Family Medicine, 8(4), 348–353. doi: 10.1370/afm.1139; 10.1370/afm.1139CrossRefGoogle ScholarPubMed
Behrens, T., Taeger, D., Wellmann, J., & Keil, U. (2004). Different methods to calculate effect estimates in cross-sectional studies. A comparison between prevalence odds ratio and prevalence ratio. Methods of Information in Medicine, 43(5), 505–509. doi: 10.1267/METH04050505Google ScholarPubMed
Boyes, A., D'Este, C., Carey, M., Lecathelinais, C., & Girgis, A. (2013). How does the distress thermometer compare to the hospital anxiety and depression scale for detecting possible cases of psychological morbidity among cancer survivors? Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, 21(1), 119–127. doi: 10.1007/s00520-012-1499-3; 10.1007/s00520-012-1499-3Google Scholar
Delgado-Guay, M., Parsons, H.A., Li, Z., Palmer, J.L., & Bruera, E. (2009). Symptom distress in advanced cancer patients with anxiety and depression in the palliative care setting. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, 17(5), 573–579. doi: 10.1007/s00520-008-0529-7; 10.1007/s00520-008-0529-7Google Scholar
Derogatis, L.R., Morrow, G.R., Fetting, J., Penman, D., Piasetsky, S., Schmale, A.M., & Carnicke, C.L. Jr., (1983). The prevalence of psychiatric disorders among cancer patients. JAMA : The Journal of the American Medical Association, 249(6), 751–757.Google Scholar
Hart, S.L., Hoyt, M.A., Diefenbach, M., Anderson, D.R., Kilbourn, K.M., Craft, L.L., & Stanton, A.L. (2012). Meta-analysis of efficacy of interventions for elevated depressive symptoms in adults diagnosed with cancer. Journal of the National Cancer Institute, 104(13), 990–1004. doi: 10.1093/jnci/djs256; 10.1093/jnci/djs256Google Scholar
Jacobsen, P.B., Donovan, K.A., Trask, P.C., Fleishman, S.B., Zabora, J., Baker, F., & Holland, J.C. (2005). Screening for psychologic distress in ambulatory cancer patients. Cancer, 103(7), 1494–1502. Retrieved from http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15726544CrossRefGoogle ScholarPubMed
Kendall, J., Glaze, K., Oakland, S., Hansen, J., & Parry, C. (2011). What do 1281 distress screeners tell us about cancer patients in a community cancer center? Psychooncology, 20(6), 594–600. doi: 10.1002/pon.1907Google Scholar
Kroenke, K., Spitzer, R.L., & Williams, J.B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.Google Scholar
Mitchell, A. J., Chan, M., Bhatti, H., Halton, M., Grassi, L., Johansen, C., & Meader, N. (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. The Lancet Oncology, 12(2), 160–174. doi: 10.1016/S1470-2045(11)70002-X; 10.1016/S1470-2045(11)70002-XGoogle Scholar
National Comprehensive Cancer Network. (2003). Distress management. clinical practice guidelines. Journal of the National Comprehensive Cancer Network : JNCCN, 1(3), 344–374.Google Scholar
Roth, A.J., Kornblith, A.B., Batel-Copel, L., Peabody, E., Scher, H.I., & Holland, J.C. (1998). Rapid screening for psychologic distress in men with prostate carcinoma: A pilot study. Cancer, 82(10), 1904–8.Google Scholar
Schneider, L. (1978). Identification of human concerns by cancer patients. In Kellogg, C.J., & Peterson Sullivan, B. (Eds.), Current perspectives in oncologic nursing. Vol. 2 (pp. 89–98). Saint Louis: The C. V. Mosby Company.Google Scholar
Teunissen, S.C., de Graeff, A., Voest, E.E., & de Haes, J.C. (2007). Are anxiety and depressed mood related to physical symptom burden? A study in hospitalized advanced cancer patients. Palliative Medicine, 21(4), 341–346. doi: 10.1177/0269216307079067Google Scholar
Von Essen, L., Larsson, G., Oberg, K., & Sjoden, P.O. (2002). ‘Satisfaction with care': Associations with health-related quality of life and psychosocial function among swedish patients with endocrine gastrointestinal tumours. Eur J Cancer Care (Engl), 11(2), 91–9.Google Scholar
Worden, J.W., & Weisman, A.D. (1980). Do cancer patients really want counseling? Gen Hosp Psychiatry, 2(2), 100–3.Google Scholar
Worden, J.W., & Weisman, A.D. (1984). Preventive psychosocial intervention with newly diagnosed cancer patients. Gen Hosp Psychiatry, 6(4), 243–9.Google Scholar
Zabora, J., BrintzenhofeSzoc, K., Curbow, B., Hooker, C., & Piantadosi, S. (2001). The prevalence of psychological distress by cancer site. Psycho-Oncology, 10(1), 19–28. Retrieved from http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=111805743.0.CO;2-6>CrossRefGoogle Scholar