Hostname: page-component-76fb5796d-vvkck Total loading time: 0 Render date: 2024-04-25T19:29:09.486Z Has data issue: false hasContentIssue false

Comparing the hospital anxiety and depression scale to the Brief Edinburgh Depression Scale for identifying cases of major depressive disorder in advanced cancer palliative patients

Published online by Cambridge University Press:  24 August 2020

Oscar Rodríguez-Mayoral*
Affiliation:
Palliative Care Service, Instituto Nacional de Cancerología, Mexico City, Mexico Facultad de Estudios Superiores “Iztacala”, Universidad Nacional Autónoma de México, Mexico City, Mexico
Adriana Peña-Nieves
Affiliation:
Palliative Care Service, Instituto Nacional de Cancerología, Mexico City, Mexico
Silvia Allende-Pérez
Affiliation:
Palliative Care Service, Instituto Nacional de Cancerología, Mexico City, Mexico
Mari Lloyd-Williams
Affiliation:
Academic Palliative and Supportive Care Studies Group (APSCSG), Institute of Psychology Health and Society, University of Liverpool, Liverpool, Merseyside, UK
*
Author for correspondence: Oscar Rodríguez-Mayoral, Palliative Care Service, Instituto Nacional de Cancerología, Av. San Fernando No. 22 Col. Sección XVI. Tlalpan, 14080Mexico City, Mexico. E-mail: oscroma@gmail.com, orodriguezm@incan.edu.mx

Abstract

Objective

This study sought to compare the Hospital Anxiety and Depression Subscale (HADS-D) and Brief Edinburgh Depression Scale (BEDS) as case-finding tools of major depressive disorder in patients with advanced cancer in a palliative care service.

Methods

An observational study was performed which included patients with advanced cancer who attended the palliative care service at the National Institute of Cancer in Mexico. Patients were asked to fill out the Hospital Anxiety and Depression Scale (HADS) and BEDS and were then assessed by a psychiatrist to evaluate major depressive disorder (MDD) as per the DSM-5 criteria. The case-finding capability of each scale was determined using receiver operating characteristic curves, assessing the area under the curve (AUC) in comparison to the clinical diagnosis.

Results

Eighty-nine patients were included; median age was 57 years, and 71% were female. Among these, 19 patients were diagnosed with MDD during the interview. When comparing the self-reported scales, BEDS had a better performance compared with HADS-D (AUC 0.8541 vs. 0.7665). Limitations include a heterogeneous population and a limited sample size.

Significance of results

The BEDS outperformed the HADS-D tool in discriminating patients with and without depression. A BEDS cutoff value of ≥5 is suggested as a case-finding score for depression in this population.

Type
Original Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2014) Manual diagnóstico y estadístico de los trastornos mentales—DSM 5. Buenos Aires: Médica Panamericana.Google Scholar
Arrieta, Ó, Angulo, LP, Núñez-Valencia, C, et al. (2013) Association of depression and anxiety on quality of life, treatment adherence, and prognosis in patients with advanced non-small cell lung cancer. Annals of Surgical Oncology 20(6), 19411948. doi:10.1245/s10434-012-2793-5CrossRefGoogle ScholarPubMed
Barriguete Meléndez, JA, Pérez Bustinzar, AR, de la Vega Morales, RI, et al. (2017) Validation of the Hospital Anxiety and Depression Scale in Mexican population with eating disorders. Revista Mexicana de Trastornos Alimentarios 8(2), 123130. doi:10.1016/j.rmta.2017.05.001CrossRefGoogle Scholar
Galindo Vázquez, O, Benjet, C, Juárez García, F, et al. (2015) Propiedades psicométricas de la Escala Hospitalaria de Ansiedad y Depresión (HADS) en una población de pacientes oncológicos mexicanos. Salud Mental 38(4), 253258. doi:10.17711/SM.0185-3325.2015.035CrossRefGoogle Scholar
Galindo Vázquez, Ó, Meneses García, A, Herrera Gómez, Á, et al. (2016) Escala Hospitalaria de Ansiedad y Depresión (HADS) en cuidadores primarios informales de pacientes con cáncer: Propiedades psicométricas. Psicooncología 12(2–3). doi:10.5209/rev_PSIC.2015.v12.n2-3.51016CrossRefGoogle Scholar
Heinze, G, Bernard-Fuentes, N, Carmona-Huerta, J, et al. (2019) Physicians specializing in psychiatry of Mexico: An update 2018. Salud Mental 42(1), 1323. doi:10.17711/SM.0185-3325.2019.003CrossRefGoogle Scholar
Jurado, S, Villegas, ME, Méndez, L, et al. (1998) La estandarización del Inventario de Depresión de Beck para los residentes de la ciudad de México. Salud Mental 21(3), 2631.Google Scholar
Kroenke, K, Theobald, D, Wu, J, et al. (2010) The association of depression and pain with health-related quality of life, disability, and health care use in cancer patients. Journal of Pain and Symptom Management 40(3), 327341. doi:10.1016/j.jpainsymman.2009.12.023CrossRefGoogle ScholarPubMed
Kumar, R and Indrayan, A (2011) Receiver operating characteristic (ROC) curve for medical researchers. Indian Pediatrics 48(4), 277287.CrossRefGoogle ScholarPubMed
Lie, HC, Hjermstad, MJ, Fayers, P, et al. (2015) Depression in advanced cancer – assessment challenges and associations with disease load. Journal of Affective Disorders 173, 176184. doi:10.1016/j.jad.2014.11.006CrossRefGoogle ScholarPubMed
Lloyd-Williams, M, Dennis, M and Taylor, F (2004) A prospective study to determine the association between physical symptoms and depression in patients with advanced cancer. Palliative Medicine 18(6), 558563. doi:10.1191/0269216304pm923oaCrossRefGoogle ScholarPubMed
López-Alvarenga, JC, Vázquez-Velázquez, V, Arcila-Martínez, D, et al. (2002) [Accuracy and diagnostic utility of the Hospital Anxiety and Depression Scale (HAD) in a sample of obese Mexican patients]. Revista De Investigacion Clinica; Organo Del Hospital De Enfermedades De La Nutricion 54(5), 403409.Google Scholar
Medina-Mora, ME, Borges, G, Benjet, C, et al. (2007) Psychiatric disorders in Mexico: Lifetime prevalence in a nationally representative sample. British Journal of Psychiatry 190(06), 521528. doi:10.1192/bjp.bp.106.025841CrossRefGoogle Scholar
Mitchell, AJ, Meader, N and Symonds, P (2010) Diagnostic validity of the Hospital Anxiety and Depression Scale (HADS) in cancer and palliative settings: A meta-analysis. Journal of Affective Disorders 126(3), 335348. doi:10.1016/j.jad.2010.01.067CrossRefGoogle ScholarPubMed
Mitchell, AJ, Chan, M, Bhatti, H, et al. (2011) Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. The Lancet Oncology 12(2), 160174. doi:10.1016/S1470-2045(11)70002-XCrossRefGoogle ScholarPubMed
Mitchell, AJ, Meader, N, Davies, E, et al. (2012) Meta-analysis of screening and case finding tools for depression in cancer: Evidence based recommendations for clinical practice on behalf of the Depression in Cancer Care consensus group. Journal of Affective Disorders 140(2), 149160. doi:10.1016/j.jad.2011.12.043CrossRefGoogle Scholar
Morita, T, Tsunoda, J, Inoue, S, et al. (1999) The Palliative Prognostic Index: A scoring system for survival prediction of terminally ill cancer patients. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer 7(3), 128133.CrossRefGoogle ScholarPubMed
Mulick, A, Walker, J, Puntis, S, et al. (2018) Does depression treatment improve the survival of depressed patients with cancer? A long-term follow-up of participants in the SMaRT Oncology-2 and 3 trials. The Lancet Psychiatry 5(4), 321326. doi:10.1016/S2215-0366(18)30061-0CrossRefGoogle Scholar
Pinquart, M and Duberstein, PR (2010) Depression and cancer mortality: A meta-analysis. Psychological Medicine 40(11), 17971810. doi:10.1017/S0033291709992285CrossRefGoogle ScholarPubMed
Rodríguez-Mayoral, O, Rodríguez-Ortíz, B, Ascencio-Huertas, L, et al. (2018) Validation of the Brief Edinburgh Depression Scale (BEDS) in a Mexican population with advanced cancer in a palliative care service. Palliative and Supportive Care, 15. doi:10.1017/S1478951518000640Google Scholar
Rodríguez-Mayoral, O, Ascencio-Huertas, L, Verástegui, E, et al. (2019) The desire to hasten death in advanced cancer patients at a Mexican palliative care service. Salud Mental 42(3), 103109. doi:10.17711/SM.0185-3325.2019.014CrossRefGoogle Scholar
Rodríguez-Mayoral, O, Cacho-Díaz, B, Peña-Nieves, A, et al. (2020) Depressive disorder and clinical factors: Impact on survival in palliative care cancer patients. General Hospital Psychiatry 64, 133-135. doi:10.1016/j.genhosppsych.2020.03.001CrossRefGoogle ScholarPubMed
Sharpe, M, Strong, V, Allen, K, et al. (2004) Major depression in outpatients attending a regional cancer centre: Screening and unmet treatment needs. British Journal of Cancer 90(2), 314320. doi:10.1038/sj.bjc.6601578CrossRefGoogle ScholarPubMed
Stata Statistical Software: Release 12. College Station, TX: StataCorp LP (2011).Google Scholar
Wakefield, CE, Butow, PN, Aaronson, NA, et al. (2015) Patient-reported depression measures in cancer: A meta-review. The Lancet Psychiatry 2(7), 635647. doi:10.1016/S2215-0366(15)00168-6CrossRefGoogle ScholarPubMed
Wilson, KG, Dalgleish, TL, Chochinov, HM, et al. (2016) Mental disorders and the desire for death in patients receiving palliative care for cancer. BMJ Supportive & Palliative Care 6(2), 170177. doi:10.1136/bmjspcare-2013-000604CrossRefGoogle ScholarPubMed
Yang, S and Berdine, G (2017) The receiver operating characteristic (ROC) curve. The Southwest Respiratory and Critical Care Chronicles 5(19), 34. doi:10.12746/swrccc.v5i19.391CrossRefGoogle Scholar
Zigmond, AS and Snaith, RP (1983) The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 67(6), 361370.CrossRefGoogle ScholarPubMed