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Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No. 18S (June 20 Supplement), 2007: 19557
Author(s):
S. Jang, J. Ackler, L. Braitman, W. Tester
Abstract:
Background: The prevalence of depression in cancer patients varies greatly, reported in the range of 5-50% depending upon the population studied. Several tools have been used to screen for depression, but it remains uncertain which tool is most valuable. The Zung self-rating depression scale (ZSDS) is one of the commonly used screening tools for depression. Using a cutoff value of > 40, one study reported sensitivity of 100% and specificity of 55% in diagnosing depression. This study was designed (1) to investigate the prevalence of major depression in our population of outpatients receiving chemotherapy, (2) to determine the correlation between the ZSDS score and Functional Assessment of Cancer Therapy - General version (FACT-G) score and (3) to examine whether statements from the FACT-G can be used as a screening tool for major depression. Methods: Sixty-two chemotherapy patients completed both ZSDS and FACT-G. Median age was 62 years (range 22-81); 55% were female. Patients with ZSDS scores > 40 were interviewed, using standard DSM-IV criteria to evaluate for major depression. Pearson’s correlation was used to examine the correlation between ZSDS and FACT-G scores. We then analyzed responses to FACT-G statements to evaluate if certain questions from the FACT-G could be used as a screening tool for major depression. Results: Thirty patients had ZSDS score < 40, and were considered to not have major depression. Among the 32 patients with ZSDS score = 40, 30 underwent clinical interviews. Seven of these 30 were diagnosed with major depression. The prevalence of major depression was 7/60, or 12% (95% CI: 5% - 23%). The ZSDS score and FACT-G score had strong correlation (R= -0.75). If the total score (range 0-24) of six statements from FACT-G were <12, then these six FACT-G statements had sensitivity of 100% and specificity of 81% in predicting major depression. Conclusions: The prevalence of major depression was 12% in our population of chemotherapy patients. The ZSDS and FACT-G scores showed strong correlation. Patient responses to six selected statements from the FACT-G appear to be useful as a screening tool for depression. A confirmatory study with larger numbers of patients is planned.
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Associated Presentation(s):