Comparison of mood disorder screening scales in geriatric oncology: THYMOG study results

Abstract

Background: Early and systematic depression screening is recommended for older patients with cancer. The objective of this study is to evaluate the performance of three different mood disorder screening scales for detection of Major Depressive Disorder (MDD) in older patients with cancer. Methods: A prospective multicentric study was conducted in patients with cancer over 70 years of age, comparing three self-administered questionnaires: the 15-item Geriatric Depression Scale (GDS-15), the Hospital Anxiety and Depression Scale - Depression (HADS-D) and the Distress Thermometer (DT). Three weeks after initial assessment, in case of score above the standard cut-off, a reassessment of the patient’s mood was performed by the primary care physician, using the DSM-V MDD diagnostic criteria and the DT. Potential differences between an abnormal mood screening test and a confirmed MDD was assessed using variance analysis for each screening scale. Results: 93 patients with an average age of 81 years [70 - 95 years] were included. 66 patients had at least one abnormal score on one of the screening scales. A MDD was confirmed for 10 of the 36 reassessed patients (28%). Abnormal screening by the GDS-15 (p=0.021), the HADS-D (p=0.018) and the DT (p=0.045) was significantly associated with MDD diagnosis. Conclusions: The three screening scales enabled detection of MDD in older patients with cancer. Among the tested scales, the HADS-D could perform best in detecting MDD. However, these screening scales may not be sufficiently reliable for MDD screening in this population. Further studies are needed to confirm the results.