Screening for depression in breast cancer patients

UOur aim in this paper was to suggest the possibility of use of the receiver operating characteristic ROC curve to establish classificatory ability of the test for depressivity in breast cancer patients.
METHODS: The authors evaluated and compared diagnostic accuracy of two well established tools for depressivity screening, the patient health questionnaire PHQ-9 for depression and Depression subscale of the Hospital Anxiety and Depression Scale HADS-D in patients with breast cancer.
RESULTS: The PHQ-9 and HADS-D were assessed and compared in terms of diagnostic accuracy and receiver operating characteristic ROC curves for Diagnostic and Statistical Manual of Mental Disorders, 4th edition diagnosis of major depressive disorder using the Composite International Diagnostic Interview for Oncology as the standard criterion.
Diagnostic accuracy of PHQ-9 and HADS-D tools in the diagnosis of depressive disorders was established, with areas under the ROC curve of 0.438 (95% confidence interval, 0.339-0.537) and 0.532 (95% confidence interval, 0.439-0.625). The questionnaires did not differ significantly in their areas under the ROC curve.
CONCLUSIONS: In patients with breast cancer, the evaluated instruments used for depression assessment, PHK-9 and HADS-D, performed satisfactorily in patient screening. The ratio of costs and benefits of routine screening procedures in all cancer patients are essential in their further management.
Key words: depressive disorder, medical psychology, receiver operating characteristic (ROC) curve