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Evaluation of screening instruments for depression and anxiety in breast cancer survivors.
Breast Cancer Res Treat. 2010 Jul; 122(2):573-8.BC

Abstract

Although cases of anxiety and depression post-breast cancer can be reliably identified using a structured psychiatric interview, such interviews are time consuming for both practitioner and patient and effective screening tools would increase detection rates. The purpose of this study was to evaluate the effectiveness of the Edinburgh Depression Scale (EDS) and the Hospital Anxiety and Depression Scale (HADS) in screening for depression and anxiety in a population of breast cancer survivors. For this purpose, The Structured Clinical Interview for the Diagnostic and Statistical Manual of mental disorders was administered to 200 breast cancer survivors to identify those suffering from an anxiety and/or depressive disorder. All study participants also completed the EDS and the HADS. Using the recommended cut-off score of >12 to screen for depression, the sensitivity and specificity of the EDS were found to be 72 and 90%, respectively. Lowering the cut-off score to >9 resulted in a sensitivity of 94% and a specificity of 78%. At the recommended cut-off score of >10, the HADS had a sensitivity of 50% and a specificity of 97% for depression, and a sensitivity of 71% and a specificity of 86% when screening for anxiety. A HADS total score (HADS-T) of >13 and an EDS of >9 had sensitivities of 96 and 91% and specificities of 74 and 84%, respectively, in screening for anxiety and/or depression. In conclusion, the study demonstrated that both the EDS and HADS can be used reliably as screening tests for anxiety and depression in this cohort. In both cases, a lower cut-off score than normally recommended delivers optimal screening properties.

Authors+Show Affiliations

Division of Mental Health, St George's University of London, London, SW17 0RE, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19960243

Citation

Alexander, Susanna, et al. "Evaluation of Screening Instruments for Depression and Anxiety in Breast Cancer Survivors." Breast Cancer Research and Treatment, vol. 122, no. 2, 2010, pp. 573-8.
Alexander S, Palmer C, Stone PC. Evaluation of screening instruments for depression and anxiety in breast cancer survivors. Breast Cancer Res Treat. 2010;122(2):573-8.
Alexander, S., Palmer, C., & Stone, P. C. (2010). Evaluation of screening instruments for depression and anxiety in breast cancer survivors. Breast Cancer Research and Treatment, 122(2), 573-8. https://doi.org/10.1007/s10549-009-0669-6
Alexander S, Palmer C, Stone PC. Evaluation of Screening Instruments for Depression and Anxiety in Breast Cancer Survivors. Breast Cancer Res Treat. 2010;122(2):573-8. PubMed PMID: 19960243.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of screening instruments for depression and anxiety in breast cancer survivors. AU - Alexander,Susanna, AU - Palmer,Clare, AU - Stone,Patrick C, Y1 - 2009/12/04/ PY - 2009/10/06/received PY - 2009/11/25/accepted PY - 2009/12/5/entrez PY - 2009/12/5/pubmed PY - 2010/9/29/medline SP - 573 EP - 8 JF - Breast cancer research and treatment JO - Breast Cancer Res Treat VL - 122 IS - 2 N2 - Although cases of anxiety and depression post-breast cancer can be reliably identified using a structured psychiatric interview, such interviews are time consuming for both practitioner and patient and effective screening tools would increase detection rates. The purpose of this study was to evaluate the effectiveness of the Edinburgh Depression Scale (EDS) and the Hospital Anxiety and Depression Scale (HADS) in screening for depression and anxiety in a population of breast cancer survivors. For this purpose, The Structured Clinical Interview for the Diagnostic and Statistical Manual of mental disorders was administered to 200 breast cancer survivors to identify those suffering from an anxiety and/or depressive disorder. All study participants also completed the EDS and the HADS. Using the recommended cut-off score of >12 to screen for depression, the sensitivity and specificity of the EDS were found to be 72 and 90%, respectively. Lowering the cut-off score to >9 resulted in a sensitivity of 94% and a specificity of 78%. At the recommended cut-off score of >10, the HADS had a sensitivity of 50% and a specificity of 97% for depression, and a sensitivity of 71% and a specificity of 86% when screening for anxiety. A HADS total score (HADS-T) of >13 and an EDS of >9 had sensitivities of 96 and 91% and specificities of 74 and 84%, respectively, in screening for anxiety and/or depression. In conclusion, the study demonstrated that both the EDS and HADS can be used reliably as screening tests for anxiety and depression in this cohort. In both cases, a lower cut-off score than normally recommended delivers optimal screening properties. SN - 1573-7217 UR - https://www.unboundmedicine.com/medline/citation/19960243/Evaluation_of_screening_instruments_for_depression_and_anxiety_in_breast_cancer_survivors_ L2 - https://doi.org/10.1007/s10549-009-0669-6 DB - PRIME DP - Unbound Medicine ER -