A review and recommendations for optimal outcome measures of anxiety, depression and general distress in studies evaluating psychosocial interventions for English-speaking adults with heterogeneous cancer diagnoses

Abstract

The HADS' efficiency and substantial track record recommend its use where anxiety, mixed affective disorders or general distress are outcomes of interest. However, continuing controversy concerning the HADS depression scale cautions against dependence where depressive disorders are of primary interest. Where cost is a concern, the POMS-37 is recommended to measure anxiety or mixed affective disorders but does not offer a suitable index of general distress and, like the HADS, emphasises anhedonia in measuring depression. Where depression is the sole focus, the CES-D is recommended.

Patient-reported depression measures in cancer: a meta-review

“…The goals of each review varied. Nine reviews assessed the suitability of depression measures as screening tools, 1,4,5,7,8,19,22,43,44 while three assessed their suitability for case-finding. 7,43,44 Several reviews examined appropriate cut-points of specific measures, 8,19,45,46 while others examined their usefulness in particular populations (eg, geriatric patients 11,42 ).…”

“…5 One review assessed the performance of measures across five stages in the cancer trajectory, 8 while others focused on mixed diagnoses and treatment stages. 3,[5][6][7]19,20,22,[43][44][45][46][47] Critical appraisal Table 2 summarizes the critical appraisal of each systematic review. All systematic reviews provided a sound rationale, a structured summary of findings, a description of their objectives and some discussion of findings (n=12).…”

“…27 After formulating the problem, the steps included (1) searching the literature, (2) gathering information from articles/reports, (3) evaluating the quality of the evidence, (4) analyzing and integrating the outcomes of research, (5) interpreting the evidence, and (6) presenting the results.…”

“…The 15-year timeframe aligns with other reviews, 5,29 and ensured that depression measures developed prior to 1999, but used (and reviewed) in the past 15 years, were included.…”

“…3,4 MedLine records that 'depression' and 'cancer' were addressed together in an average of 192 citations/year in the 1980's, rising to an average of >1000 citations/year between 2006-2015. 5,6 Mirroring this rise, clinicians and researchers have utilized numerous patient-reported outcome measures to assess depression in individuals affected by cancer. 4,7,8,9 Unrecognized and untreated depression can have deleterious implications for long term quality of life, 11,12 treatment adherence 13 health service use, 14,15 requests for death, 11 and mortality.…”