The Phenomenology and Screening of Clinical Depression in Cancer Patients

• Published in: Journal of psychosocial oncology Vol. 26; no. 1; pp. 31 - 51
• Main Authors: Hopko, Derek R., Bell, John L., Armento, Maria E. A., Robertson, Sarah M. C., Hunt, Melissa K., Wolf, Nicole J., Mullane, Christen
• Format: Journal Article
• Language: English
• Published: New York, NY Taylor & Francis 01.01.2008; Haworth Press; Taylor & Francis LLC
• Subjects: Adult and adolescent clinical studies; assessment; Biological and medical sciences; Cancer; Case-Control Studies; Clinical Social Work; Depression; Depression (Psychology); Depressive Disorder, Major - etiology; Depressive Disorder, Major - prevention & control; Evaluation; Female; Humans; Male; Mass Screening - methods; Medical diagnosis; Medical sciences; Medical screening; Mental depression; Middle Aged; Mood disorders; Neoplasms - psychology; Patients; Phenomenology; Psychological Tests; Psychology; Psychology. Psychoanalysis. Psychiatry; psychometric properties; Psychopathology. Psychiatry; Quality of Life; Reproducibility of Results; screening; Sensitivity and Specificity; Tennessee; Treatment; Tennessee; Mood disorder; Human; Evaluation; screening; Psychometrics; Depression; psychometric properties; Malignant tumor; Medical screening; Phenomenology; Test validation; assessment; Cancer
• ISSN: 0734-7332; 1540-7586
• DOI: 10.1300/J077v26n01_03

Clinical depression is the most common psychiatric disorder among cancer patients and is associated with significant functional impairment. Unfortunately, depression in cancer patients is often under-diagnosed and untreated, and studies examining the predictive utility of assessment instruments in detecting clinically depressed cancer patients are sparse. Using a structured interview, thirty-three patients with various cancer types were diagnosed as having major depression (n = 24) or no psychiatric diagnosis (n = 9). All patients were administered the Beck Depression Inventory-II (BDI-II), the Center for Epidemiological Studies in Depression Scale (CES-D), Hamilton Rating Scale for Depression (HRSD), Quality of Life Inventory (QOLI), a medical and psychosocial functioning questionnaire (SF-36), and given co-morbidity of depression with anxiety disorders, the Beck Anxiety Inventory (BAI). Depressed and non-depressed cancer patients were compared and contrasted across all assessment measures and accuracy of instruments was based on evaluating their sensitivity, specificity, and positive predictive values. Depressed cancer patients exhibited more severe depressive symptoms and poorer quality of life, increased anxiety and bodily pain, and decreased vitality and social functioning. All instruments exhibited strong predictive properties, with the CES-D and BDI-II considered most feasible given their time efficiency, administrative simplicity, and strong psychometric properties.