Hospital anxiety and depression scale cutoff scores for cancer patients in acute care

Abstract

The aim of this study was to determine optimal cutoff scores for the Hospital Anxiety and Depression Scale (HADS) when used in evaluating cancer patients in acute care. A total of 689 cancer patients were assessed during their first days of in-patient treatment, using the structured clinical interview for DSM and the HADS. Statistical analysis was performed using ROC curves. A total of 222 patients (32%) had a mental disorder. The area under the curve was the best in the total scale of the HADS, namely 0.73. With a score of X13, it is possible to detect 76% of the cases with a specificity of .60, whereas 95% of the cases can be detected with a score of X6 (specificity 0.21). With scores of X16 and X22, recommended by the test authors for primary care, only 59 and 30% of the comorbid cancer patients are indicated. Lower HADS cutoff scores when preferable when evaluating cancer patients than are recommended for use in primary care. When using HADS in clinical practice and epidemiological studies, it is important to decide whether, for the task at hand, high detection rates of affected patients or low misclassification rates are more important.

Evaluation of screening instruments for depression and anxiety in breast cancer survivors

“…However, when screening for depression in cancer patients, studies suggest that the HADS-D should be used with caution due to the variability in optimal cut-off scores [12]. Although not recommended by the original authors, HADS-A and HADS-D can be combined to produce a total score (HADS-T), used as a screen for general psychological distress [13][14][15]. Ravazi et al suggested that a score[13 is an appropriate cut-off to screen specifically for adjustment disorders and major depressive disorders in cancer in-patients.…”

“…Ravazi et al suggested that a score[13 is an appropriate cut-off to screen specifically for adjustment disorders and major depressive disorders in cancer in-patients. A more recent study suggests that a cut-off [12 offers optimal sensitivity and specificity in screening for all types of psychological distress in cancer in-patients [15]. We are not aware of studies validating HADS-T cut-off scores for psychological distress in disease-free cancer survivors.…”

Ansiedad, depresión y afrontamiento en pacientes con cáncer testicular en tratamiento y periodo de seguimiento

“…Durante el proceso oncológico principalmente en el periodo de tratamiento, la presencia de depresión constituye una constante en la vida del paciente con cán-cer (11,12,35) .…”

“…La presencia de ansiedad y depresión en el paciente con CT se encuentran asociadas con la edad joven, la nuliparidad, la neuropatía periférica, el desempleo, los problemas económicos, problemas por el consumo excesivo de alcohol, problemas sexuales y haber sido tratados por problemas de salud mental previamente (9)(10) . En el paciente oncológico ambas patología psicológicas pueden afectar la evolución de la enfermedad, tratamiento y pronóstico, puesto que tienen como consecuencia un menor nivel de adherencia terapéutica y calidad de vida; incluso persistiendo después de que se ha completado el tratamiento (3,11,12) . En este contexto el tipo de afrontamiento que adopte el paciente ante el cáncer y su tratamiento puede representar un mecanismo adaptativo, y en sentido contrario una mayor disfuncionalidad (13,14) .…”

Self-Esteem, Pain and Suicidal Thoughts in a Sample of Cancer Patients

“…The subjects who have scores of at least 1 on VAS were considered as with pain (n=58). Turkish version (18) of Hospital Anxiety and Depression Scale (HADS), the most widely used tool for assessing psychological morbidity in cancer patients was administered to measure the severity of anxiety and depression (19,20). HADS consists of 14 brief items divided into two subscales designed to screen for anxiety and depressive symptoms.…”