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Two-question screening can detect depression in radiotherapy patients

Tuesday September 24, 2013
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A two-item questionnaire can effectively identify cancer patients receiving radiotherapy who could be suffering from depression, according to research.

The study, presented Sept. 23 at the American Society for Radiation Oncology’s 55th annual meeting in Atlanta, screened 455 patients receiving radiation treatment at 37 centers throughout the U.S. Participants in the study were seeking treatment for breast cancer (45%), GI cancer (11%), lung cancer (10%), gynecologic cancer (6%) or other cancers (27%). Of the patients in the study, 66% were women.

Study participants were screened for depression before or within two weeks of treatment for the initial cancer diagnosis. The screening forms included the single-item National Comprehensive Cancer Network-Distress Thermometer, the Hopkins Symptom Checklist and the nine-item Patient Health Questionnaire, which includes Patient Health Questionnaire-2 as its first two questions. All participants answered the screening questionnaires with 100% completion.

Patients received the PHQ-9 and were asked if, within the past two weeks, they had “little interest or pleasure in doing things,” or “if they were feeling down, depressed or hopeless.”

Within the study, a total of 75 patients (16%) screened positively for depressive symptoms. PHQ-9 and PHQ-2 had similar accuracy in detecting depression and were superior to the HLSC-25 and the NCCN-DT.

Of the facilities included in the study, 68% offer mental health services. Patients who screened positive for depression symptoms and a systematic sample of patients who screened negative, were administered the Structured Clinical Interview for DSM-IV Mood Disorder modules by telephone.

“Detection of depression in cancer patients is an important public health priority, and the ability to screen and treat cancer patients for depression can have a major impact on a patient’s quality of life,” William Small Jr., MD, FASTRO, presenting author of the study and chairman of the Department of Radiation Oncology at Loyola University Chicago, said in a news release.

The researchers also found screening in a radiotherapy setting was feasible and well-received by patients.

“This study was designed to test the feasibility of screening for major depression in cancer patients receiving radiation therapy,” said Lynn I. Wagner, PhD, the study’s principal investigator and an associate professor in the Department of Psychiatry and Behavioral Sciences at Northwestern University’s Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center at Northwestern University in Chicago, in the release. “The ability of a two-question survey to effectively screen for depression will hopefully prompt more centers to screen and to refer patients in need of mental health services.”

The research was supported by the Radiation Oncology Therapy Group’s Community Clinical Oncology Program.


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