Kugaya A, Akechi T, Okuyama T, Okamura H, Uchitomi Y
Department of Psychiatry, National Cancer Center Hospital East, Chiba, Japan.
Jpn J Clin Oncol. 1998 May;28(5):333-8. doi: 10.1093/jjco/28.5.333.
Psychological distress is frequently observed, however, it is underestimated in cancer patients. The aim of this study is to develop a simple battery for screening for psychological distress, adjustment disorder and major depressive disorder in Japanese cancer patients.
One hundred and twenty-eight cancer patients were interviewed by psychiatrists and tested using the Hospital Anxiety and Depression Scale (HADS), a 14-item self-assessment questionnaire. Psychiatric diagnoses were performed according to the Diagnostic and Statistical Manual of Mental Disorders, third edition-revised.
Cronbach alpha values of the Japanese version of the scale were 0.77 for the subscale for anxiety and 0.79 for depression. By a receiver operating characteristic analysis, we determined that an optimal cut-off point for screening for adjustment disorder and major depressive disorder was 10/11, which gave high enough sensitivity and specificity (91.5 and 65.4%, respectively). To screen for major depressive disorder alone, 19/20 was an optimal cut-off point with 82.4% sensitivity and 96.3% specificity. The subscales of HADS (anxiety and depression) also had high screening performance.
The Japanese version of HADS is a sensitive and specific tool for screening for psychological distress in Japanese cancer patients. This scale can be used for an early detection of patients' psychological distress which may be followed by psychiatric interventions.
心理困扰在癌症患者中很常见，但却常常被低估。本研究旨在开发一套简单的测评方法，用于筛查日本癌症患者的心理困扰、适应障碍和重度抑郁症。
128名癌症患者接受了精神科医生的访谈，并使用医院焦虑抑郁量表（HADS，一份14项的自评问卷）进行测试。根据《精神疾病诊断与统计手册》第三版修订本进行精神疾病诊断。
该量表日文版焦虑分量表的克朗巴哈α系数为0.77，抑郁分量表为0.79。通过受试者工作特征分析，我们确定筛查适应障碍和重度抑郁症的最佳临界值为10/11，其灵敏度和特异度足够高（分别为91.5%和65.4%）。单独筛查重度抑郁症时，最佳临界值为19/20，灵敏度为82.4%，特异度为96.3%。HADS的分量表（焦虑和抑郁）也具有较高的筛查效能。
HADS日文版是筛查日本癌症患者心理困扰的一种灵敏且特异的工具。该量表可用于早期发现患者的心理困扰，随后可进行精神科干预。
