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Screening for depression in head and neck cancer
Mark R Katz1, Neil Kopek, John Waldron
1Psychosocial Oncology and Palliative Care Program, Department of Psychiatry, Ontario, Canada. mark.katz@uhn.on.ca
Psycho-Oncology
|April 1, 2004
Summary
A significant minority of head and neck cancer patients experience depression post-radiation. Accurate depression screening is possible using the Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), or CES-D scale.
Area of Science:
- Oncology
- Psychiatry
- Medical Screening
Background:
- Head and neck cancer patients undergoing radiation therapy are at high risk for depression.
- Life-threatening illness and treatment side effects like oral morbidity contribute to this risk.
Purpose of the Study:
- To determine the prevalence of depression in this patient group.
- To evaluate the accuracy of common depression screening instruments.
Main Methods:
- Sixty patients were assessed for Major and Minor Depression using the Schedule for Affective Disorders and Schizophrenia (SADS).
- Screening tools included the Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), and CES-D scale.
- Accuracy was measured using sensitivity, specificity, positive predictive values (PPV), and Receiver Operating Characteristic (ROC) curves.
Main Results:
- The prevalence of Major and Minor Depression was 20%.
- All tested instruments demonstrated high accuracy, with no statistically significant differences observed.
- The HADS showed the highest sensitivity, specificity, and PPV. No Major Depression cases were missed.
Conclusions:
- A substantial number of head and neck cancer patients experience depression after radiation treatment.
- Effective depression screening is feasible in this population using the BDI, HADS, or CES-D.