Assessment of depression in cancer patients

It is widely known that depression exists in patients with cancer. The prevalence, however, varies widely by study and is often attributable to differences in assessment procedures. Attempts to identify accurate methods of assessing depression in cancer patients have employed different diagnostic approaches, assessment methods (e.g., self-report versus interview), and inclusion criteria. Unfortunately, all of these variables affect conclusions that can be drawn regarding the presence of depression in cancer patients. Other variables that can further affect the assessment of depression in cancer patients include individual differences such as the patient's age, gender, race/ethnicity, hospitalization status, and type and stage of cancer. Finally, the specific assessor and the timing of the assessment also likely affect conclusions about depression in cancer patients. This review was designed to succinctly address all of the above issues and identify several areas for future research, including refining diagnostic criteria for depression in cancer patients; creating cancer-specific depression measures with appropriate cutoffs; focusing on the issues of age, race, ethnicity, subculture, and type and stage of cancer in creating depression assessment tools; and exploring the issues of clinical versus subclinical depression, who and when to assess, and timely and cost-effective ways to assess.