Validity of the Brief Symptom Inventory-18 (BSI-18) for identifying depression and anxiety in young adult cancer survivors: Comparison with a Structured Clinical Diagnostic Interview.

Abstract

The Brief Symptom Inventory-18 (BSI-18) is widely used to assess psychological symptoms in cancer survivors, but the validity of conventional BSI-18 cut-off scores in this population has been questioned. This study assessed the accuracy of the BSI-18 for identifying significant anxiety and depression in young adult cancer survivors (YACS), by comparing it to a “gold standard” diagnostic interview measure. Two hundred and fifty young adult cancer survivors (YACS), age 18–40 completed the BSI-18 and the Structured Clinical Interview for DSM-IV (SCID) interview assessing anxiety and depressive disorders. BSI-18 results were compared to SCID criteria using ROC analyses. Forty-four participants (17.7%) met criteria for ≥ 1 SCID diagnoses, and an additional 20 (8.0%) met criteria for clinically significant SCID symptoms without a diagnosis. General concordance between the BSI-18 GSI scale and SCID diagnosis was good (AUC = 0.848), but the two most widely used BSI-18 case-rules failed to identify a majority of survivors with SCID diagnoses, and no alternative BSI-18 cut-off scores met study criteria for clinical screening. Analyses aimed at identifying survivors with significant SCID symptoms or a SCID diagnosis had similar results, as did analyses examining depression and anxiety separately. The BSI-18 shows good overall concordance with a psychiatric interview, but recommended cut-off scores fail to identify a majority of YACS with psychiatric diagnosis. Clinicians should not rely on the BSI-18 alone as a screening measure for YACS. Alternative BSI-18 scoring algorithms optimized for detecting psychiatric symptoms in YACS may be an important step to address this limitation.

Screening young adult cancer survivors with the PROMIS Depression Short Form (PROMIS‐D‐SF): Comparison with a structured clinical diagnostic interview

“…A highly accurate depression screen in YACS would be very useful for oncologists and other providers, who could rely on it in a similar manner to determine which YACS require further evaluation for depression. Unfortunately, consistent with the results of studies of several other symptom checklist screening measures, the current study results indicated that the PROMIS‐D‐SF is not sufficiently sensitive and specific to be used as a stand‐alone screening tool for depression in YACS.…”

Screening for emotional disorders in patients with cancer using the Brief Symptom Inventory (BSI) and the BSI‐18 versus a standardized psychiatric interview (the World Health Organization Composite International Diagnostic Interview)

“…71,72 Taken together, our current results confirm the usefulness of the BSI in its original 53-item form for screening and case finding in patients with cancer who have a definite psychiatric diagnosis, as assessed by a standardized clinical interview instead of other nondiagnostic psychometric tools used in other studies. Regarding the BSI-18, we confirmed the caveats for the use of case-rule cutoff scores recently raised by Recklitis et al 39 in young adult survivors of cancer, indicating that, compared with using psychiatric interviews to make psychiatric diagnoses according to the DSM, general concordance between the BSI-18 GSI scale and psychiatric diagnosis was good; however, the 2 most widely used BSI-18 case rules failed to identify the majority of survivors who had a DSM psychiatric diagnosis. In our study, we indeed confirmed that the Recklitis et al GSI T-score cutoff of 50 maximized sensitivity and specificity for case detection; however, we also identified another cutoff score (48) that supported the clinical value of the BSI-18.…”

“…A strong limitation of current research is that very few data are available regarding the case‐finding properties of the BSI‐18 compared with a formal psychiatric assessment, which indeed is the reference gold standard for diagnosis, rather than the other psychometric tools used in most studies to examine accuracy in detecting caseness. With respect to this, a recent study of 250 young adult cancer survivors indicated that the BSI‐18 had good overall concordance with the SCID psychiatric interview for making diagnoses according to the DSM, but the recommended cutoff scores failed to identify the majority of patients with psychiatric diagnosis …”

“…With respect to this, a recent study of 250 young adult cancer survivors indicated that the BSI-18 had good overall concordance with the SCID psychiatric interview for making diagnoses according to the DSM, but the recommended cutoff scores failed to identify the majority of patients with psychiatric diagnosis. 39 Given this background, the objective of the current study was to examine the characteristics of the BSI and its shorter version (the BSI-18) compared with a structured psychiatric interview, as a gold standard, among patients with cancer in Italy and within a wider European study. [40][41][42]…”

Psychological symptoms of ordinary Chinese citizens based on SCL-90 during the level I emergency response to COVID-19

“…In this study, GSI T-scores ≥ 63 was considered as the high-risk group for psychological symptoms and GSI T-scores < 63 as was considered as the low-risk group for psychological symptoms with for further psychological evaluation. The GSI T-score threshold has been proven valid and reliable marker for identifying severe psychological condition that requires assessment and possible intervention, and it has been used extensively in psychological researches in recent years (Arneiro et al, 2018;Black et al, 1998;Fauerbach et al, 2007;Monteiro et al, 2017;Otte et al, 2017;Recklitis et al, 2017).…”