Affective syndromes and their screening in cancer patients with early and stable disease: Italian ICD-10 data and performance of the Distress Thermometer from the Southern European Psycho-Oncology Study (SEPOS).

BACKGROUND

The assessment of mood and anxiety disorders secondary to cancer by using easy-to-administer instruments has been the object of recent research.

METHODS

The aim of this study was to examine the accuracy of the short screening tool developed by the National Comprehensive Cancer Network Clinical Practice Guidelines for Distress Management, (0-10 point-scale Distress Thermometer) (DT) in detecting affective syndrome disorders in Italian cancer patients. The sample consisted of 109 cancer outpatients who were administered the ICD-10 psychiatric interview (CIDI), the DT and the Hospital Anxiety Depression Scale (HADS).

RESULTS

Forty-four patients (40.4%) met the criteria for an ICD-10 diagnosis of affective syndromes. The DT was significantly associated with HADS-Total score (r=0.66, p=0.001). A cut-off > or = 4 on the DT showed a sensitivity of 79.5% and a specificity of 75.4% (positive predictive value--PPV = 68.6%; negative predictive value--NPV = 84.5%). The cut-off score > or = 10 on the HADS was associated with a sensitivity of 86% and a specificity of 81.5% (PPV = 76%; NPV = 89.9%). A cut-off score > or = 5 on DT and > or = 15 on HADS maximized sensitivity (78.6% and 85%, respectively) and specificity (83.1% and 96%, respectively) for patients with more severe affective syndromes (major depression, persistent depressive disorders).

CONCLUSIONS

The results suggest that simple instruments can be used as feasible tools in the screening of mood and anxiety disorders among cancer patients.