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Routine depression screening and diagnosing strategy for cancer inpatients.

Chun-Hsien Tu1, Mei-Chi Hsu, Shu-Ching Chi

  • 1Department of Psychiatry, E-Da Hospital, Kaohsiung, Taiwan; Department of Nursing, College of Medicine, I-Shou University, Kaohsiung, Taiwan.

Psycho-Oncology
|May 7, 2014
PubMed
Summary

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Routine screening effectively identifies major depressive disorder (MDD) and other depressive disorders in cancer inpatients. This two-stage approach is practical for comprehensive cancer care systems.

Area of Science:

  • Oncology
  • Psychiatry
  • Clinical Screening

Background:

  • Clinical guidelines advocate for systematic depression screening in cancer patients.
  • Early recognition and management of depression are crucial for cancer patient care.
  • This study investigated the utility of a structured tool for screening major depressive disorder (MDD) in cancer inpatients.

Purpose of the Study:

  • To screen for major depressive disorder (MDD) in cancer inpatients using a structured tool.
  • To evaluate the applicability and effectiveness of a two-stage screening and diagnosis strategy.
  • To determine the prevalence of MDD and other depressive disorders in this population.

Main Methods:

  • Nurses routinely screened cancer inpatients using the Taiwanese Depression Questionnaire (TDQ).
Keywords:
Taiwanese Depression Questionnairecancerdiagnostic accuracymajor depressive disorderroutine depression screening

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  • Positive screens led to non-mandated psychiatric referrals for evaluation and diagnosis.
  • A total of 8800 patients were screened, with 298 completing the full two-stage procedure.

    • Main Results:

    • Routine screening identified 1087 (26.9%) patients with positive first-time screens.
    • Depressive disorders were diagnosed in 185 patients (62.1%), including adjustment disorder (23.8%) and MDD (21.5%).
    • The estimated prevalence of MDD was 21.5%, with the TDQ showing optimal diagnostic accuracy at a cutoff score of ≧26 (AUC=0.72).

    Conclusions:

    • A two-stage depression screening and diagnosis strategy is practical for cancer care.
    • This method improves the recognition of MDD and other depressive disorders in cancer patients.
    • The strategy can be routinely applied within comprehensive cancer care systems.