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The Hospital Anxiety and Depression Scale (HADS) and the 9-item Patient Health Questionnaire (PHQ-9) as screening instruments for depression in patients with cancer

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The Hospital Anxiety and Depression Scale (HADS) and the 9-item Patient Health Questionnaire (PHQ-9) as screening instruments for depression in patients with cancer. / Hartung, Tim J.; Friedrich, Michael; Johansen, Christoffer; Wittchen, Hans-Ulrich; Faller, Herman; Koch, Uwe; Brähler, Elmar; Härter, Martin; Keller, Monika; Schulz, Holger; Wegscheider, Karl; Weis, Joachim; Mehnert, Anja.

In: CANCER-AM CANCER SOC, Vol. 123, No. 21, 01.11.2017, p. 4236-4243.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Hartung, TJ, Friedrich, M, Johansen, C, Wittchen, H-U, Faller, H, Koch, U, Brähler, E, Härter, M, Keller, M, Schulz, H, Wegscheider, K, Weis, J & Mehnert, A 2017, 'The Hospital Anxiety and Depression Scale (HADS) and the 9-item Patient Health Questionnaire (PHQ-9) as screening instruments for depression in patients with cancer', CANCER-AM CANCER SOC, vol. 123, no. 21, pp. 4236-4243. https://doi.org/10.1002/cncr.30846

APA

Hartung, T. J., Friedrich, M., Johansen, C., Wittchen, H-U., Faller, H., Koch, U., Brähler, E., Härter, M., Keller, M., Schulz, H., Wegscheider, K., Weis, J., & Mehnert, A. (2017). The Hospital Anxiety and Depression Scale (HADS) and the 9-item Patient Health Questionnaire (PHQ-9) as screening instruments for depression in patients with cancer. CANCER-AM CANCER SOC, 123(21), 4236-4243. https://doi.org/10.1002/cncr.30846

Vancouver

Hartung TJ, Friedrich M, Johansen C, Wittchen H-U, Faller H, Koch U et al. The Hospital Anxiety and Depression Scale (HADS) and the 9-item Patient Health Questionnaire (PHQ-9) as screening instruments for depression in patients with cancer. CANCER-AM CANCER SOC. 2017 Nov 1;123(21):4236-4243. https://doi.org/10.1002/cncr.30846

Bibtex

@article{f3d43b2d695b4ac891b7db8e5c55b531,
title = "The Hospital Anxiety and Depression Scale (HADS) and the 9-item Patient Health Questionnaire (PHQ-9) as screening instruments for depression in patients with cancer",
abstract = "BACKGROUND: Depression screening in patients with cancer is recommended by major clinical guidelines, although the evidence on individual screening tools is limited for this population. Here, the authors assess and compare the diagnostic accuracy of 2 established screening instruments: the depression modules of the 9-item Patient Health Questionnaire (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS-D), in a representative sample of patients with cancer.METHODS: This multicenter study was conducted with a proportional, stratified, random sample of 2141 patients with cancer across all major tumor sites and treatment settings. The PHQ-9 and HADS-D were assessed and compared in terms of diagnostic accuracy and receiver operating characteristic (ROC) curves for Diagnostic and Statistical Manual of Mental Disorders, 4th edition diagnosis of major depressive disorder using the Composite International Diagnostic Interview for Oncology as the criterion standard.RESULTS: The diagnostic accuracy of the PHQ-9 and HADS-D was fair for diagnosing major depressive disorder, with areas under the ROC curves of 0.78 (95% confidence interval, 0.76-0.79) and 0.75 (95% confidence interval, 0.74-0.77), respectively. The 2 questionnaires did not differ significantly in their areas under the ROC curves (P = .15). The PHQ-9 with a cutoff score ≥7 had the best screening performance, with a sensitivity of 83% (95% confidence interval, 78%-89%) and a specificity of 61% (95% confidence interval, 59%-63%). The American Society of Clinical Oncology guideline screening algorithm had a sensitivity of 44% (95% confidence interval, 36%-51%) and a specificity of 84% (95% confidence interval, 83%-85%).CONCLUSIONS: In patients with cancer, the screening performance of both the PHQ-9 and the HADS-D was limited compared with a standardized diagnostic interview. Costs and benefits of routinely screening all patients with cancer should be weighed carefully. ",
keywords = "Journal Article",
author = "Hartung, {Tim J.} and Michael Friedrich and Christoffer Johansen and Hans-Ulrich Wittchen and Herman Faller and Uwe Koch and Elmar Br{\"a}hler and Martin H{\"a}rter and Monika Keller and Holger Schulz and Karl Wegscheider and Joachim Weis and Anja Mehnert",
note = "{\textcopyright} 2017 American Cancer Society.",
year = "2017",
month = nov,
day = "1",
doi = "10.1002/cncr.30846",
language = "English",
volume = "123",
pages = "4236--4243",
journal = "CANCER-AM CANCER SOC",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "21",

}

RIS

TY - JOUR

T1 - The Hospital Anxiety and Depression Scale (HADS) and the 9-item Patient Health Questionnaire (PHQ-9) as screening instruments for depression in patients with cancer

AU - Hartung, Tim J.

AU - Friedrich, Michael

AU - Johansen, Christoffer

AU - Wittchen, Hans-Ulrich

AU - Faller, Herman

AU - Koch, Uwe

AU - Brähler, Elmar

AU - Härter, Martin

AU - Keller, Monika

AU - Schulz, Holger

AU - Wegscheider, Karl

AU - Weis, Joachim

AU - Mehnert, Anja

N1 - © 2017 American Cancer Society.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - BACKGROUND: Depression screening in patients with cancer is recommended by major clinical guidelines, although the evidence on individual screening tools is limited for this population. Here, the authors assess and compare the diagnostic accuracy of 2 established screening instruments: the depression modules of the 9-item Patient Health Questionnaire (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS-D), in a representative sample of patients with cancer.METHODS: This multicenter study was conducted with a proportional, stratified, random sample of 2141 patients with cancer across all major tumor sites and treatment settings. The PHQ-9 and HADS-D were assessed and compared in terms of diagnostic accuracy and receiver operating characteristic (ROC) curves for Diagnostic and Statistical Manual of Mental Disorders, 4th edition diagnosis of major depressive disorder using the Composite International Diagnostic Interview for Oncology as the criterion standard.RESULTS: The diagnostic accuracy of the PHQ-9 and HADS-D was fair for diagnosing major depressive disorder, with areas under the ROC curves of 0.78 (95% confidence interval, 0.76-0.79) and 0.75 (95% confidence interval, 0.74-0.77), respectively. The 2 questionnaires did not differ significantly in their areas under the ROC curves (P = .15). The PHQ-9 with a cutoff score ≥7 had the best screening performance, with a sensitivity of 83% (95% confidence interval, 78%-89%) and a specificity of 61% (95% confidence interval, 59%-63%). The American Society of Clinical Oncology guideline screening algorithm had a sensitivity of 44% (95% confidence interval, 36%-51%) and a specificity of 84% (95% confidence interval, 83%-85%).CONCLUSIONS: In patients with cancer, the screening performance of both the PHQ-9 and the HADS-D was limited compared with a standardized diagnostic interview. Costs and benefits of routinely screening all patients with cancer should be weighed carefully.

AB - BACKGROUND: Depression screening in patients with cancer is recommended by major clinical guidelines, although the evidence on individual screening tools is limited for this population. Here, the authors assess and compare the diagnostic accuracy of 2 established screening instruments: the depression modules of the 9-item Patient Health Questionnaire (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS-D), in a representative sample of patients with cancer.METHODS: This multicenter study was conducted with a proportional, stratified, random sample of 2141 patients with cancer across all major tumor sites and treatment settings. The PHQ-9 and HADS-D were assessed and compared in terms of diagnostic accuracy and receiver operating characteristic (ROC) curves for Diagnostic and Statistical Manual of Mental Disorders, 4th edition diagnosis of major depressive disorder using the Composite International Diagnostic Interview for Oncology as the criterion standard.RESULTS: The diagnostic accuracy of the PHQ-9 and HADS-D was fair for diagnosing major depressive disorder, with areas under the ROC curves of 0.78 (95% confidence interval, 0.76-0.79) and 0.75 (95% confidence interval, 0.74-0.77), respectively. The 2 questionnaires did not differ significantly in their areas under the ROC curves (P = .15). The PHQ-9 with a cutoff score ≥7 had the best screening performance, with a sensitivity of 83% (95% confidence interval, 78%-89%) and a specificity of 61% (95% confidence interval, 59%-63%). The American Society of Clinical Oncology guideline screening algorithm had a sensitivity of 44% (95% confidence interval, 36%-51%) and a specificity of 84% (95% confidence interval, 83%-85%).CONCLUSIONS: In patients with cancer, the screening performance of both the PHQ-9 and the HADS-D was limited compared with a standardized diagnostic interview. Costs and benefits of routinely screening all patients with cancer should be weighed carefully.

KW - Journal Article

U2 - 10.1002/cncr.30846

DO - 10.1002/cncr.30846

M3 - SCORING: Journal article

C2 - 28654189

VL - 123

SP - 4236

EP - 4243

JO - CANCER-AM CANCER SOC

JF - CANCER-AM CANCER SOC

SN - 0008-543X

IS - 21

ER -