Efficiency of Screening for Depression in Cancer Patients Receiving Radiotherapy
- Assess the feasibility of a screening procedure for major depression in cancer patients
undergoing definitive or palliative radiotherapy.
- Establish the rates of major depression identified through diagnostic telephone
- Estimate the false negative rate (1-sensitivity) and false positive rate
(1-specificity) of the 9-item Patient Health Questionnaire (PHQ-9) and the 25-item
Hopkins Symptom Checklist (HSCL-25).
- Compare the false negative rate of 2 items addressing mood disturbance on the PHQ-9
relative to all 9-items on the PHQ-9 and to the HSCL-25.
- Examine the sensitivity to changes in depression severity of the PHQ-9, the HSCL-25,
and the Structured Clinical Interview for DSM-IV (SCID) .
- Correlate both depressive symptoms and major depression in terms of sociodemographic
and clinical variables.
- Establish the nature and adequacy of existing care, patient preferences, treatment
availability, and barriers to depression treatment utilization for patients identified
with major depression using the Assessment of Mental Health Services and Barriers to
- Assess rates of continued elevations of depressive symptoms, seeking and receipt of
care, and barriers to care at follow-up in these patients.
- Examine the differences in study objectives based on institution characteristics with
regard to existing psychosocial services that are provided on-site and integrated in
OUTLINE: This is a multicenter study.
- Depression screening: Patients complete screening depression questionnaires, including
the Hopkins Symptom Checklist (HSCL-25) and the 9-item Patient Health Questionnaire
(PHQ-9) that includes a 2-item PHQ, and a Health Status Questionnaire at baseline.
- Diagnostic telephone interview: Within 2 weeks, patients who screen positive for
depression and select patients who screen negative for depression undergo a diagnostic
telephone interview that includes modules of the Structured Clinical Interview for
Diagnosis-DSM-IV (SCID) related to major depression, bipolar disorder, adjustment
disorders, and queries concerning past and current mental health treatment and barriers
to treatment. The Assessment of Mental Health Services and Barriers of Care
questionnaire is also administered by the clinical interviewer. Clinical interviewers
provide patients who are found to be depressed with a list of community resources, and
offer assistance in obtaining treatment, if needed. Patients are also encouraged to
discuss these options with their oncology health care team.
- Follow-up interview: At 3 months, patients who receive a research diagnosis of major
depression, dysthymia, bipolar disorder, or cancer-related adjustment disorder in the
initial SCID-DSM-IV undergo another diagnostic telephone interview and are reassessed
for the initiation and continuation of treatment, current depressive symptoms, and
receipt of cancer care. The HSCL-25, PHQ-9, and Assessment of Mental Health Services
and Barriers of Care questionnaires and the SCID-DSM-IV are also administered by the
clinical interviewer. Treatment options and referrals are discussed with patients who
remain depressed and are not in treatment.
Feasibility of a screening procedure for major depression
Lynne Wagner, MD
Robert H. Lurie Cancer Center
United States: Federal Government
|CCOP - North Shore University Hospital||Manhasset, New York 11030|
|CCOP - Grand Rapids||Grand Rapids, Michigan 49503|
|Hulston Cancer Center at Cox Medical Center South||Springfield, Missouri 65807|
|St. John's Regional Health Center||Springfield, Missouri 65804|
|Long Island Jewish Medical Center||New Hyde Park, New York 11040|
|Mission Hospitals - Memorial Campus||Asheville, North Carolina 28801|
|St. Vincent Hospital Regional Cancer Center||Green Bay, Wisconsin 54307-3508|
|St. Mary's Hospital Medical Center - Green Bay||Green Bay, Wisconsin 54303|
|Saint Anthony's Hospital at Saint Anthony's Health Center||Alton, Illinois 62002|
|David C. Pratt Cancer Center at St. John's Mercy||St. Louis, Missouri 63141|
|Butterworth Hospital at Spectrum Health||Grand Rapids, Michigan 49503-2560|
|Bryn Mawr Hospital||Bryn Mawr, Pennsylvania 19010|
|Lankenau Cancer Center at Lankenau Hospital||Wynnewood, Pennsylvania 19096|
|FirstHealth Moore Regional Community Hospital Comprehensive Cancer Center||Pinehurst, North Carolina 28374|
|Pardee Memorial Hospital||Hendersonville, North Carolina 28791|
|Cancer Center of Paoli Memorial Hospital||Paoli, Pennsylvania 19301-1792|