Faculty of Health, Deakin University, Burwood, Victoria, Australia.
J Psychosoc Oncol. 2011;29(3):231-41. doi: 10.1080/07347332.2011.563347.
This study assessed the relative screening performance of the Distress Impact Thermometer (DIT) and cutoff levels with the established clinical case threshold of the Hospital Anxiety and Depression Scale (HADS) among a sample of colorectal cancer (CRC) survivors. Fifty-nine CRC survivors completed the DIT, HADS, and provided demographic information at baseline, and 45 of these patients completed the same measures at follow-up, giving a total of 104 participant data. Receiver operating characteristic (ROC) analysis was performed to determine the accuracy of the DIT compared to the HADS, with a cutoff score ≥8 on each HADS subscale (depression and anxiety) and ≥15 on the HADS total scale used to identify patients with psychological distress. The sample comprised slightly more males (63%) than females, with an average age of 59 years (SD = 9.53) and ranging from 33 to 77 years. The optimum DT cutoff score of ≥5 yielded a sensitivity of 60% and specificity of 86.1%; the area under the curve was 0.771 (95% confidence interval [CI] [0.646, 0.896]). For the depression subscale, the DT performed better on specificity than sensitivity, however the opposite was true for the anxiety subscale. The addition of an impact thermometer did not enhance screening performance. The results of this study provide support for a DT score of ≥5 for detecting psychological distress among CRC survivors and do not support the addition of an impact thermometer. The use of the DT might underestimate depression but overestimate anxiety.
本研究评估了在结直肠癌（CRC）幸存者样本中，困扰影响温度计（DIT）与既定的医院焦虑和抑郁量表（HADS）临床病例阈值的相对筛查性能。59 名 CRC 幸存者在基线时完成了 DIT、HADS，并提供了人口统计学信息，其中 45 名患者在随访时完成了相同的测量，共有 104 名参与者的数据。进行了受试者工作特征（ROC）分析，以确定 DIT 与 HADS 的准确性，每个 HADS 子量表（抑郁和焦虑）的截断值≥8，HADS 总分的截断值≥15，用于识别有心理困扰的患者。该样本中男性（63%）略多于女性，平均年龄为 59 岁（SD=9.53），年龄范围为 33 岁至 77 岁。最佳 DT 截断值≥5 的灵敏度为 60%，特异性为 86.1%；曲线下面积为 0.771（95%置信区间[CI] [0.646, 0.896]）。对于抑郁子量表，DT 在特异性上的表现优于灵敏度，但在焦虑子量表上则相反。添加影响温度计并没有提高筛查性能。本研究的结果为 CRC 幸存者中 DT 评分≥5 用于检测心理困扰提供了支持，但不支持添加影响温度计。DT 的使用可能低估了抑郁，但高估了焦虑。
