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Forbes E, Clover K, Oultram S, Wratten C, Kumar M, Tieu MT, Carter G, McCarter K, Britton B, Baker AL. Situational anxiety in head and neck cancer: Rates, patterns and clinical management interventions in a regional cancer setting. J Med Radiat Sci 2024; 71:100-109. [PMID: 37888792 PMCID: PMC10920933 DOI: 10.1002/jmrs.736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
INTRODUCTION Research indicates that the immobilisation mask required for radiation therapy (RT) for head and neck cancers can provoke intense anxiety. However, little is known about the rates of this anxiety, whether it changes over a course of treatment and how it is managed in clinical practice. This study aimed to describe the rates and patterns of situational anxiety in patients undergoing RT for head and neck cancer and the use of anxiety management interventions in current clinical practice in a major regional cancer setting in New South Wales, Australia. METHODS Situational anxiety rates and patterns were assessed at five time points using the State-Trait Anxiety Inventory prior to treatment planning (SIM), the first three treatment sessions (Tx 1, Tx 2 and Tx 3) and treatment 20 (Tx 20). Sessions were observed to record the use of general supportive interventions (music and support person) and anxiety-specific interventions (break from the mask, relaxation techniques and anxiolytic medication). Sociodemographic and clinical information was extracted from the medical record. RESULTS One hundred and one patients were recruited. One-third had clinically significant anxiety at any of the first three time points (33.3-40%), and a quarter at Tx 3 (26.4%) and Tx 20 (23.4%). Of the sample, 55.4% had available data for categorisation into one of four pattern groups: 'No Anxiety' (46.4%); 'Decreasing Anxiety' (35.7%); 'Increasing Anxiety' (7.1%); and 'Stable High Anxiety' (10.7%). Most participants had social support present at SIM (53.5%) and listened to music during treatment (86.7-92.9%). Few participants received relaxation techniques alone (1.2-2.3%). Anxiolytic medication was provided for 10% of patients at some stage during the treatment journey and 5% required a break from the mask at SIM, with frequency decreasing throughout the treatment course. CONCLUSIONS In this regional cancer setting, situational anxiety was common, but generally decreased throughout treatment. Some patients experience persistent or increasing anxiety, with up to 10% of patients receiving specific anxiety management interventions.
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Affiliation(s)
- Erin Forbes
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Kerrie Clover
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- PsychoOncology Service, Department of Consultation Liaison PsychiatryCalvary Mater NewcastleWaratahNew South WalesAustralia
| | - Sharon Oultram
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Radiation Oncology DepartmentCalvary Mater NewcastleWaratahNew South WalesAustralia
| | - Chris Wratten
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Radiation Oncology DepartmentCalvary Mater NewcastleWaratahNew South WalesAustralia
| | - Mahesh Kumar
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Radiation Oncology DepartmentCalvary Mater NewcastleWaratahNew South WalesAustralia
| | - Minh Thi Tieu
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Radiation Oncology DepartmentCalvary Mater NewcastleWaratahNew South WalesAustralia
| | - Gregory Carter
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Department of Consultation Liaison PsychiatryCalvary Mater NewcastleWaratahNew South WalesAustralia
| | - Kristen McCarter
- School of Psychological Sciences, College of Science, Engineering and EnvironmentUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Ben Britton
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter New England Mental Health ServicesNewcastleNew South WalesAustralia
| | - Amanda L. Baker
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
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Forbes E, Baker AL, Britton B, Clover K, Skelton E, Moore L, Handley T, Oultram S, Oldmeadow C, Gibberd A, McCarter K. A systematic review of nonpharmacological interventions to reduce procedural anxiety among patients undergoing radiation therapy for cancer. Cancer Med 2023; 12:20396-20422. [PMID: 37803922 PMCID: PMC10652309 DOI: 10.1002/cam4.6573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 08/30/2023] [Accepted: 09/12/2023] [Indexed: 10/08/2023] Open
Abstract
Procedural anxiety is a concern for a number of patients undergoing radiation therapy. While procedural anxiety is often treated pharmacologically, there is a clinical need for effective alternative strategies for patients who are contraindicated from medication use, and those who prefer not to take unnecessary medications. OBJECTIVES The primary objective was to assess the efficacy of nonpharmacological interventions delivered to adults with cancer, in the radiation oncology department, just prior to, or during radiation therapy, in reducing levels of self-reported procedural anxiety. The secondary objectives were to assess the efficacy of these interventions in reducing physiological symptoms of procedural anxiety and anxiety-related treatment disruptions. DESIGN Systematic review. DATA SOURCES Electronic databases (MEDLINE, CINAHL, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials) were searched from inception up until February 2022. INCLUSION CRITERIA Population: Adult patients with cancer undergoing external beam radiation therapy. INTERVENTION Nonpharmacological interventions delivered within the radiation therapy department. Comparison: standard care controls, or standard care plus an alternative intervention. OUTCOMES level of self-reported procedural anxiety (primary), physiological symptoms of anxiety (secondary) and measures of anxiety-related treatment disruptions (secondary). DATA EXTRACTION AND ANALYSIS Two reviewers independently extracted data. A meta-analysis was originally planned but deemed not feasible as the studies could not be confidently pooled for meta-analysis, due to the variability in the interventions, study designs and the generally low number of studies. Therefore, a narrative synthesis is presented. RESULTS Screening of 2363 records identified nine studies that met inclusion criteria: six studies of music interventions, two of video-based patient education and one of aromatherapy. Overall, three studies received a global rating of strong methodological quality and low risk of bias. Three studies reported a significant effect of the intervention on reducing the primary outcome of self-reported procedural anxiety: two music interventions (both strong methodological quality), and one video-based patient education (moderate methodological quality). One of the studies (a music intervention) also reported a significant reduction in the secondary outcome of physiological symptoms of procedural anxiety (systolic blood pressure). CONCLUSIONS The evidence for nonpharmacological interventions delivered to adults with cancer just prior to, or during radiation therapy, in reducing levels of self-reported procedural anxiety is limited, with very few well-designed studies. There is a need for interventions for procedural anxiety during radiation therapy to be evaluated through rigorous randomised controlled trials.
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Affiliation(s)
- Erin Forbes
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanAustralia
| | - Amanda L. Baker
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanAustralia
| | - Ben Britton
- Hunter New England Mental Health ServicesNewcastleAustralia
| | - Kerrie Clover
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanAustralia
- Psycho‐Oncology Service, Department of Consultation Liaison PsychiatryCalvary Mater NewcastleWaratahAustralia
| | - Eliza Skelton
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanAustralia
| | - Lyndell Moore
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanAustralia
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders UniversityBedford ParkAustralia
| | - Tonelle Handley
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanAustralia
| | - Sharon Oultram
- Department of Radiation OncologyCalvary Mater NewcastleWaratahAustralia
| | | | - Alison Gibberd
- Data Sciences, Hunter Medical Research InstituteNew LambtonAustralia
| | - Kristen McCarter
- School of Psychological Sciences, College of Engineering, Science and EnvironmentUniversity of NewcastleCallaghanAustralia
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Forbes E, Clover K, Baker AL, Britton B, Carlson M, McCarter K. 'Having the mask on didn't worry me until … they clamped my head down so I wouldn't move': A qualitative study exploring anxiety in patients with head and neck cancer during radiation therapy. J Med Radiat Sci 2023; 70:283-291. [PMID: 36724485 PMCID: PMC10500108 DOI: 10.1002/jmrs.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/11/2023] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION More than 20% of patients undergoing radiation therapy for head and neck cancer report anxiety specifically related to the immobilisation mask, a tight-fighting mask patients are required to wear for the duration of each treatment session. However, limited research has investigated this from the patient perspective. The aim of this study was to better understand patient experiences of mask anxiety during head and neck cancer radiation therapy and to explore patient attitudes toward potential strategies that may reduce mask anxiety during this treatment. METHODS Five patients with head and neck cancer, who had self-reported mask anxiety during radiation therapy, participated in semi-structured, qualitative interviews exploring their experiences of anxiety and suggestions for reducing anxiety. A codebook thematic analysis was conducted. RESULTS Six main themes were identified: (1) triggers of anxiety; (2) adjusting to radiation therapy; (3) education about the mask; (4) coping; (5) motivation and (6) improving the patient experience. CONCLUSION Findings from these interviews provide valuable insight into how and when healthcare providers may be able to assist patients to manage mask anxiety. Recommendations include increased communication from health care providers; delivery of visual information to improve patient preparedness; exposure/opportunities to interact with the masks prior to treatment commencing and increased control of music/soundtrack selection. However, a limitation of this study is the small sample size and further research is warranted.
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Affiliation(s)
- Erin Forbes
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Kerrie Clover
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- PsychoOncology Service, Department of Consultation Liaison PsychiatryCalvary Mater NewcastleCallaghanNew South WalesAustralia
| | - Amanda L. Baker
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Ben Britton
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter New England Mental Health ServicesNewcastleNew South WalesAustralia
| | - Melissa Carlson
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Kristen McCarter
- School of Psychological Sciences, College of Science, Engineering and EnvironmentUniversity of NewcastleCallaghanNew South WalesAustralia
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Wu Y, Levis B, Daray FM, Ioannidis JPA, Patten SB, Cuijpers P, Ziegelstein RC, Gilbody S, Fischer FH, Fan S, Sun Y, He C, Krishnan A, Neupane D, Bhandari PM, Negeri Z, Riehm KE, Rice DB, Azar M, Yan XW, Imran M, Chiovitti MJ, Boruff JT, McMillan D, Kloda LA, Markham S, Henry M, Ismail Z, Loiselle CG, Mitchell ND, Al-Adawi S, Beck KR, Beraldi A, Bernstein CN, Boye B, Büel-Drabe N, Bunevicius A, Can C, Carter G, Chen CK, Cheung G, Clover K, Conroy RM, Costa-Requena G, Cukor D, Dabscheck E, De Souza J, Downing M, Feinstein A, Ferentinos PP, Flint AJ, Gallagher P, Gandy M, Grassi L, Härter M, Hernando A, Jackson ML, Jenewein J, Jetté N, Julião M, Kjærgaard M, Köhler S, König HH, Krishna LKR, Lee Y, Löbner M, Loosman WL, Love AW, Löwe B, Malt UF, Marrie RA, Massardo L, Matsuoka Y, Mehnert A, Michopoulos I, Misery L, Nelson CJ, Ng CG, O'Donnell ML, O'Rourke SJ, Öztürk A, Pabst A, Pasco JA, Peceliuniene J, Pintor L, Ponsford JL, Pulido F, Quinn TJ, Reme SE, Reuter K, Riedel-Heller SG, Rooney AG, Sánchez-González R, Saracino RM, Schellekens MPJ, Scherer M, Benedetti A, Thombs BD, Et Al. Comparison of the accuracy of the 7-item HADS Depression subscale and 14-item total HADS for screening for major depression: A systematic review and individual participant data meta-analysis. Psychol Assess 2023; 35:95-114. [PMID: 36689386 DOI: 10.1037/pas0001181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The seven-item Hospital Anxiety and Depression Scale Depression subscale (HADS-D) and the total score of the 14-item HADS (HADS-T) are both used for major depression screening. Compared to the HADS-D, the HADS-T includes anxiety items and requires more time to complete. We compared the screening accuracy of the HADS-D and HADS-T for major depression detection. We conducted an individual participant data meta-analysis and fit bivariate random effects models to assess diagnostic accuracy among participants with both HADS-D and HADS-T scores. We identified optimal cutoffs, estimated sensitivity and specificity with 95% confidence intervals, and compared screening accuracy across paired cutoffs via two-stage and individual-level models. We used a 0.05 equivalence margin to assess equivalency in sensitivity and specificity. 20,700 participants (2,285 major depression cases) from 98 studies were included. Cutoffs of ≥7 for the HADS-D (sensitivity 0.79 [0.75, 0.83], specificity 0.78 [0.75, 0.80]) and ≥15 for the HADS-T (sensitivity 0.79 [0.76, 0.82], specificity 0.81 [0.78, 0.83]) minimized the distance to the top-left corner of the receiver operating characteristic curve. Across all sets of paired cutoffs evaluated, differences of sensitivity between HADS-T and HADS-D ranged from -0.05 to 0.01 (0.00 at paired optimal cutoffs), and differences of specificity were within 0.03 for all cutoffs (0.02-0.03). The pattern was similar among outpatients, although the HADS-T was slightly (not nonequivalently) more specific among inpatients. The accuracy of HADS-T was equivalent to the HADS-D for detecting major depression. In most settings, the shorter HADS-D would be preferred. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Federico M Daray
- Institute of Pharmacology, School of Medicine, University of Buenos Aires
| | | | - Scott B Patten
- Department of Community Health Sciences, University of Calgary
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit
| | | | - Simon Gilbody
- Department of Health Sciences, Hull York Medical School, University of York
| | - Felix H Fischer
- Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin
| | - Suiqiong Fan
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | | | - Zelalem Negeri
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Xin Wei Yan
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | | | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University
| | - Dean McMillan
- Department of Health Sciences, Hull York Medical School, University of York
| | | | - Sarah Markham
- Department of Biostatistics and Health Informatics, King's College London
| | - Melissa Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Zahinoor Ismail
- Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary
| | | | | | - Samir Al-Adawi
- Department of Behavioural Medicine, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Kevin R Beck
- Department of Psychiatry, Singapore General Hospital, Singapore
| | - Anna Beraldi
- kbo Lech-Mangfall-Klinik für Psychatrie, Psychotherapie und Psychsomatik, Garmisch-Partenkirchen
| | | | - Birgitte Boye
- Department of Behavioural Medicine, University of Oslo
| | | | | | - Ceyhun Can
- Adana City Training and Research Hospital
| | - Gregory Carter
- School of Medicine and Public Health, University of Newcastle
| | - Chih-Ken Chen
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Gary Cheung
- Department of Psychological Medicine, University of Auckland
| | - Kerrie Clover
- Centre for Brain and Mental Health Research, University of Newcastle
| | - Ronán M Conroy
- Division of Population Health Sciences, Royal College of Surgeons in Ireland
| | - Gema Costa-Requena
- Department of Psychiatry, Clinical Psychology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Centro de Investigacióo Biomédica en Red de Salud Mental
| | | | | | | | | | | | - Panagiotis P Ferentinos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens
| | | | | | - Milena Gandy
- The School of Psychological Sciences, Macquarie University
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg, University of Hamburg
| | | | | | - Josef Jenewein
- Department of Medical Psychology and Psychotherapy, Medical University of Graz
| | - Nathalie Jetté
- Department of Neurology, Icahn School of Medicine at Mount Sinai
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra
| | - Marie Kjærgaard
- Endocrinology Research Group, Medical Clinic, University Hospital of North Norway
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf
| | | | - Yu Lee
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig
| | | | | | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf
| | - Ulrik F Malt
- Department of Research and Education Division of Surgery and Clinical Neuroscience, University of Oslo
| | - Ruth Ann Marrie
- Department of Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba
| | - Loreto Massardo
- Centro de Biología Celular y Biomedicina, Facultad de Medicina y Ciencia, Universidad San Sebastián
| | - Yutaka Matsuoka
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University of Leipzig
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens
| | | | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Chong Guan Ng
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya
| | | | | | | | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig
| | - Julie A Pasco
- The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University
| | - Jurate Peceliuniene
- Faculty of Medicine, Clinic of Internal Diseases, Family Medicine and Oncology, Vilnius University
| | - Luis Pintor
- Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer
| | | | | | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow
| | - Silje E Reme
- Department of Psychology, Faculty of Social Sciences, University of Oslo
| | - Katrin Reuter
- Private Practice for Psychotherapy and Psycho-oncology, Freiburg, Baden-Württemberg
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig
| | | | - Roberto Sánchez-González
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Centre Emili Mira, Parc de Salut Mar
| | - Rebecca M Saracino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | | | - Martin Scherer
- Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital
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Forbes E, Clover K, Baker AL, McCarter KL, Oultram S, Kumar M, Wratten C, Tieu MT, Nixon J, Britton B. Biofeedback Enabled CALM (BeCALM)-the feasibility of biofeedback on procedural anxiety during radiation therapy: study protocol for a pilot randomised controlled trial. BMJ Open 2022; 12:e062467. [PMID: 36600369 PMCID: PMC9730381 DOI: 10.1136/bmjopen-2022-062467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Patients undergoing treatment for cancer who require radiation therapy (RT) report anxiety specifically relating to the RT procedure. Procedural anxiety can be detrimental to treatment delivery, causing disruptions to treatment sessions, or treatment avoidance. Acute procedural anxiety is most commonly managed with anxiolytic medication. There is a need for effective, non-pharmacological interventions for patients not suitable for, or who prefer to avoid, anxiolytic medication. The primary objectives of this pilot trial are to evaluate the: (1) feasibility of conducting the Biofeedback Enabled CALM (BeCALM) intervention during RT treatment sessions; (2) acceptability of the BeCALM intervention among patients; and (3) acceptability of the BeCALM intervention among radiation therapists. The secondary objective of this pilot trial is to examine the potential effectiveness of the BeCALM intervention delivered by radiation therapists to reduce procedural anxiety during RT. METHODS AND ANALYSIS This is a pilot randomised controlled trial. A researcher will recruit adult patients with cancer (3-month recruitment period) scheduled to undergo RT and meeting eligibility criteria for procedural anxiety at the Calvary Mater Hospital, Newcastle (NSW), Australia. Participants will be randomly assigned to receive treatment as usual or the BeCALM intervention (biofeedback plus brief breathing techniques). The primary outcomes are feasibility (measured by recruitment, retention rates and percentage of treatment sessions in which the intervention was successfully delivered); radiation therapists perceived feasibility and acceptability (survey responses); and patient perceived acceptability (survey responses). Secondary outcome is potential effectiveness of the intervention (as measured by the State Trait Anxiety Inventory-State subscale; the Distress Thermometer; and an analysis of treatment duration). ETHICS AND DISSEMINATION The study protocol has received approval from Hunter New England Health Human Research Ethics Committee (2021/ETH11356). The results will be disseminated via peer-reviewed publications, as well as presentation at relevant conferences. TRIAL REGISTRATION NUMBER ACTRN12621001742864.
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Affiliation(s)
- Erin Forbes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Kerrie Clover
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- PsychoOncology Service, Department of Consultation Liaison Psychiatry, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Kristen Louise McCarter
- School of Psychological Sciences, College of Science, Engineering and Environment, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Sharon Oultram
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Mahesh Kumar
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Chris Wratten
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Minh Thi Tieu
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Jodie Nixon
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Ben Britton
- Mental Health Services, Hunter New England Health, New Lambton, New South Wales, Australia
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Clover K, Lambert SD, Oldmeadow C, Britton B, Mitchell AJ, Carter G, King MT. Convergent and criterion validity of PROMIS anxiety measures relative to six legacy measures and a structured diagnostic interview for anxiety in cancer patients. J Patient Rep Outcomes 2022; 6:80. [PMID: 35857151 PMCID: PMC9300804 DOI: 10.1186/s41687-022-00477-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/05/2022] [Indexed: 12/03/2022] Open
Abstract
Background Detecting anxiety in oncology patients is important, requiring valid yet brief measures. One increasingly popular approach is the Patient Reported Outcomes Measurement Information System (PROMIS); however, its validity is not well established in oncology. We assessed the convergent and criterion validity of PROMIS anxiety measures in an oncology sample.
Methods 132 oncology/haematology outpatients completed the PROMIS Anxiety Computer Adaptive Test (PROMIS-A-CAT) and the 7 item (original) PROMIS Anxiety Short Form (PROMIS-A-SF) along with six well-established measures: Hospital Anxiety and Depression Scale-Anxiety (HADS-A); Generalised Anxiety Disorder-7 (GAD-7); Depression, Anxiety and Stress Scale-Anxiety (DASS-A) and Stress (DASS-S); Distress Thermometer (DT) and PSYCH-6. Correlations, area under the curve (AUC) and diagnostic accuracy statistics were calculated with Structured Clinical Interview as the reference standard.
Results Both PROMIS measures correlated with all legacy measures at p < .001 (Rho = .56–.83). AUCs (> .80) were good for both PROMIS measures and comparable to or better than all legacy measures. At the recommended mild cut-point (55), PROMIS-A-SF had sensitivity (.67) comparable to or better than all the legacy measures, whereas PROMIS-A-CAT sensitivity (.59) was lower than GAD-7 (.67) and HADS-A (.62), but comparable to PSYCH-6 and higher than DASS-A, DASS-S and DT. Sensitivity for both was .79. A reduced cut-point of 51 on both PROMIS measures improved sensitivity (.83–.84) although specificity was only adequate (.61–.62). Conclusions The convergent and criterion validity of the PROMIS anxiety measures in cancer populations was confirmed as equivalent, but not superior to, established measures (GAD-7 and HADS-A). The PROMIS-A-CAT did not demonstrate clear advantages over PROMIS-A-SF.
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Clover K, Lambert SD, Oldmeadow C, Britton B, King MT, Mitchell AJ, Carter GL. Apples to apples? Comparison of the measurement properties of hospital anxiety and depression-anxiety subscale (HADS-A), depression, anxiety and stress scale-anxiety subscale (DASS-A), and generalised anxiety disorder (GAD-7) scale in an oncology setting using Rasch analysis and diagnostic accuracy statistics. Curr Psychol 2022. [DOI: 10.1007/s12144-020-00906-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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8
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Brehaut E, Neupane D, Levis B, Wu Y, Sun Y, Krishnan A, He C, Bhandari PM, Negeri Z, Riehm KE, Rice DB, Azar M, Yan XW, Imran M, Chiovitti MJ, Saadat N, Cuijpers P, Ioannidis JPA, Markham S, Patten SB, Ziegelstein RC, Henry M, Ismail Z, Loiselle CG, Mitchell ND, Tonelli M, Boruff JT, Kloda LA, Beraldi A, Braeken APBM, Carter G, Clover K, Conroy RM, Cukor D, da Rocha E Silva CE, De Souza J, Downing MG, Feinstein A, Ferentinos PP, Fischer FH, Flint AJ, Fujimori M, Gallagher P, Goebel S, Jetté N, Julião M, Keller M, Kjærgaard M, Love AW, Löwe B, Martin-Santos R, Michopoulos I, Navines R, O'Rourke SJ, Öztürk A, Pintor L, Ponsford JL, Rooney AG, Sánchez-González R, Schwarzbold ML, Sharpe M, Simard S, Singer S, Stone J, Tung KY, Turner A, Walker J, Walterfang M, White J, Benedetti A, Thombs BD. Depression prevalence using the HADS-D compared to SCID major depression classification: An individual participant data meta-analysis. J Psychosom Res 2020; 139:110256. [PMID: 33069051 DOI: 10.1016/j.jpsychores.2020.110256] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/01/2020] [Accepted: 09/19/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Validated diagnostic interviews are required to classify depression status and estimate prevalence of disorder, but screening tools are often used instead. We used individual participant data meta-analysis to compare prevalence based on standard Hospital Anxiety and Depression Scale - depression subscale (HADS-D) cutoffs of ≥8 and ≥11 versus Structured Clinical Interview for DSM (SCID) major depression and determined if an alternative HADS-D cutoff could more accurately estimate prevalence. METHODS We searched Medline, Medline In-Process & Other Non-Indexed Citations via Ovid, PsycINFO, and Web of Science (inception-July 11, 2016) for studies comparing HADS-D scores to SCID major depression status. Pooled prevalence and pooled differences in prevalence for HADS-D cutoffs versus SCID major depression were estimated. RESULTS 6005 participants (689 SCID major depression cases) from 41 primary studies were included. Pooled prevalence was 24.5% (95% Confidence Interval (CI): 20.5%, 29.0%) for HADS-D ≥8, 10.7% (95% CI: 8.3%, 13.8%) for HADS-D ≥11, and 11.6% (95% CI: 9.2%, 14.6%) for SCID major depression. HADS-D ≥11 was closest to SCID major depression prevalence, but the 95% prediction interval for the difference that could be expected for HADS-D ≥11 versus SCID in a new study was -21.1% to 19.5%. CONCLUSIONS HADS-D ≥8 substantially overestimates depression prevalence. Of all possible cutoff thresholds, HADS-D ≥11 was closest to the SCID, but there was substantial heterogeneity in the difference between HADS-D ≥11 and SCID-based estimates. HADS-D should not be used as a substitute for a validated diagnostic interview.
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Affiliation(s)
- Eliana Brehaut
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Staffordshire, UK.
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada.
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Parash Mani Bhandari
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
| | - Zelalem Negeri
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Psychology, McGill University, Montréal, Québec, Canada.
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
| | - Xin Wei Yan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Matthew J Chiovitti
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.
| | - John P A Ioannidis
- Department of Medicine, Department of Epidemiology and Population Health, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, CA, USA.
| | - Sarah Markham
- Department of Biostatistics and Health Informatics, King's College London, London, UK.
| | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada; Cuthbertson & Fischer Chair in Pediatric Mental Health, University of Calgary, Calgary, Canada.
| | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Melissa Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Zahinoor Ismail
- Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, Clinical Neuroscience and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Carmen G Loiselle
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Ingram School of Nursing, McGill University, Montréal, Québec, Canada; Centre for Nursing Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Oncology, Faculty of Medicine, McGill University, Montréal, Québec, Canada.
| | - Nicholas D Mitchell
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Alberta Health Services, Edmonton, Alberta, Canada.
| | - Marcello Tonelli
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada.
| | - Lorie A Kloda
- Library, Concordia University, Montréal, Québec, Canada.
| | - Anna Beraldi
- kbo Lech-Mangfall-Klinik für Psychatrie, Psychotherapie und Psychsomatik, Garmisch-Partenkirchen, Bayern, Germany.
| | - Anna P B M Braeken
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands; Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands; Department of Health Services Research, CAPHRI School for Public Health and Primary, Maastricht University, Maastricht, The Netherlands.
| | - Gregory Carter
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Calvary Mater Newcastle, Australia.
| | - Kerrie Clover
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, Australia.
| | - Ronán M Conroy
- Royal College of Surgeons in Ireland Division of Population Health Sciences, Dublin, Ireland.
| | | | - Carlos E da Rocha E Silva
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Jennifer De Souza
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK; University of Birmingham, Birmingham, UK.
| | - Marina G Downing
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Monash Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, VIC, Australia.
| | - Anthony Feinstein
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
| | - Panagiotis P Ferentinos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece; Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
| | - Felix H Fischer
- Department of Psychiatry, McGill University, Montréal, Québec, Canada; Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
| | - Alastair J Flint
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada.
| | - Maiko Fujimori
- Section of Psychological Science, Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
| | | | - Simone Goebel
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Christian-Albrechts University, Kiel, Germany.
| | - Nathalie Jetté
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal.
| | - Monika Keller
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Germany.
| | - Marie Kjærgaard
- Endocrinology Research Group, Medical Clinic, University Hospital of North Norway, Norway; Department of Internal Medicine, Kolding Hospital, Hospital Lillebaelt, Denmark.
| | - Anthony W Love
- Department of Psychology, Victoria University, Victoria, Australia.
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain.
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Ricard Navines
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain.
| | - Suzanne J O'Rourke
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK. Suzanne.O'
| | | | - Luis Pintor
- Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, Spain; Consultation Liaison Psychiatry Unit, Hospital Clínico de Barcelona, Barcelona, Spain.
| | - Jennie L Ponsford
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Monash Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, VIC, Australia.
| | - Alasdair G Rooney
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK; Robert Fergusson Unit, Royal Edinburgh Hospital, NHS Lothian, Edinburgh, UK.
| | - Roberto Sánchez-González
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Centre Emili Mira, Parc de Salut Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain.
| | - Marcelo L Schwarzbold
- Department of Internal Medicine, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Michael Sharpe
- Department of Psychological Medicine, University of Oxford, Oxford, UK.
| | - Sébastien Simard
- Département des sciences de la santé, Université du Québec à Chicoutimi (UQAC), Québec, Canada; Centre intersectoriel en santé durable (CISD), Québec, Canada; Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ), Québec, Canada.
| | - Susanne Singer
- University Medical Centre Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics, Mainz, Germany.
| | - Jon Stone
- Department of Neurology, University of Edinburgh, Edinburgh, UK.
| | | | - Alyna Turner
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, VIC, Australia.
| | - Jane Walker
- Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia; Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
| | - Jennifer White
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada; Department of Medicine, McGill University, Montréal, Québec, Canada.
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada; Department of Psychology, McGill University, Montréal, Québec, Canada; Department of Medicine, McGill University, Montréal, Québec, Canada; Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada; Biomedical Ethics Unit, McGill University, Montréal, Québec, Canada.
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9
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Forbes E, Baker AL, Britton B, Clover K, Skelton E, Oultram S, Oldmeadow C, McCarter K. Non-pharmacological approaches to procedural anxiety reduction for patients undergoing radiotherapy for cancer: systematic review protocol. BMJ Open 2020; 10:e035155. [PMID: 33039983 PMCID: PMC7549444 DOI: 10.1136/bmjopen-2019-035155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Procedural anxiety relates to an affective state of anxiety or fear in relation to a medical procedure. Various treatment-related factors may elicit anxiety among oncology patients, including fear of diagnostic imaging (such as MRI scans) and impending treatment and medical procedures (such as chemotherapy and radiotherapy). It is common in oncology settings to manage acute anxiety relating to medical procedures with anxiolytic medication. However, pharmacological approaches are not suitable for many patients. Despite this, non-pharmacological interventions are infrequently used. The aim of this systematic review is to determine whether non-pharmacological interventions delivered prior to, or during, radiotherapy are effective in reducing procedural anxiety. METHODS AND ANALYSIS Data sources will include the bibliographic databases CINAHL, MEDLINE, EMBASE, PsycINFO and Cochrane Central Register of Controlled trials (CENTRAL) (from inception onward). Eligible studies will include adult patients with cancer undergoing radiotherapy treatment. Included studies will be those which employ a non-pharmacological intervention, delivered within existing radiotherapy appointments, with the aim of reducing procedural anxiety related to radiotherapy. All research designs with a control or other comparison group will be included. The primary outcome will be change in levels of self-reported procedural anxiety. Secondary outcomes will be changes in scores on physiological measures of anxiety and/or changes in treatment completion and/or changes in treatment duration and/or changes in psychological distress. Two investigators will independently complete title and abstract screening, full-text screening, data extraction and assessment of methodological quality. If appropriate, a meta-analyses will be performed. Any important amendments to this protocol will be updated in the PROSPERO registration and documented in the resulting review publication. ETHICS AND DISSEMINATION No ethical issues are anticipated from this review. The findings will be disseminated through peer-reviewed publication and at conferences by presentation. SYSTEMATIC REVIEW REGISTRATION CRD42019112941.
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Affiliation(s)
- Erin Forbes
- School of Medicine and Public Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
| | - Ben Britton
- Department of Consultation Liaison Psychiatry, John Hunter Hospital, New Lambton, New South Wales, Australia
| | - Kerrie Clover
- School of Medicine and Public Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
- Psycho-Oncology, Calvary Mater Newcastle, Hunter Region Mail Centre, New South Wales, Australia
| | - Eliza Skelton
- School of Medicine and Public Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
| | - Sharon Oultram
- Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Christopher Oldmeadow
- CREDITSS-Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Kristen McCarter
- School of Medicine and Public Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
- Priority Research Centre for Cancer Research, Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
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10
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Levis B, Benedetti A, Ioannidis JPA, Sun Y, Negeri Z, He C, Wu Y, Krishnan A, Bhandari PM, Neupane D, Imran M, Rice DB, Riehm KE, Saadat N, Azar M, Boruff J, Cuijpers P, Gilbody S, Kloda LA, McMillan D, Patten SB, Shrier I, Ziegelstein RC, Alamri SH, Amtmann D, Ayalon L, Baradaran HR, Beraldi A, Bernstein CN, Bhana A, Bombardier CH, Carter G, Chagas MH, Chibanda D, Clover K, Conwell Y, Diez-Quevedo C, Fann JR, Fischer FH, Gholizadeh L, Gibson LJ, Green EP, Greeno CG, Hall BJ, Haroz EE, Ismail K, Jetté N, Khamseh ME, Kwan Y, Lara MA, Liu SI, Loureiro SR, Löwe B, Marrie RA, Marsh L, McGuire A, Muramatsu K, Navarrete L, Osório FL, Petersen I, Picardi A, Pugh SL, Quinn TJ, Rooney AG, Shinn EH, Sidebottom A, Spangenberg L, Tan PLL, Taylor-Rowan M, Turner A, van Weert HC, Vöhringer PA, Wagner LI, White J, Winkley K, Thombs BD. Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis. J Clin Epidemiol 2020; 122:115-128.e1. [PMID: 32105798 DOI: 10.1016/j.jclinepi.2020.02.002] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 02/08/2020] [Accepted: 02/18/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Depression symptom questionnaires are not for diagnostic classification. Patient Health Questionnaire-9 (PHQ-9) scores ≥10 are nonetheless often used to estimate depression prevalence. We compared PHQ-9 ≥10 prevalence to Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) major depression prevalence and assessed whether an alternative PHQ-9 cutoff could more accurately estimate prevalence. STUDY DESIGN AND SETTING Individual participant data meta-analysis of datasets comparing PHQ-9 scores to SCID major depression status. RESULTS A total of 9,242 participants (1,389 SCID major depression cases) from 44 primary studies were included. Pooled PHQ-9 ≥10 prevalence was 24.6% (95% confidence interval [CI]: 20.8%, 28.9%); pooled SCID major depression prevalence was 12.1% (95% CI: 9.6%, 15.2%); and pooled difference was 11.9% (95% CI: 9.3%, 14.6%). The mean study-level PHQ-9 ≥10 to SCID-based prevalence ratio was 2.5 times. PHQ-9 ≥14 and the PHQ-9 diagnostic algorithm provided prevalence closest to SCID major depression prevalence, but study-level prevalence differed from SCID-based prevalence by an average absolute difference of 4.8% for PHQ-9 ≥14 (95% prediction interval: -13.6%, 14.5%) and 5.6% for the PHQ-9 diagnostic algorithm (95% prediction interval: -16.4%, 15.0%). CONCLUSION PHQ-9 ≥10 substantially overestimates depression prevalence. There is too much heterogeneity to correct statistically in individual studies.
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Affiliation(s)
- Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada; Department of Medicine, McGill University, Montréal, Québec, Canada
| | - John P A Ioannidis
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA; Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA; Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA; Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, USA
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Zelalem Negeri
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Parash Mani Bhandari
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Psychology, McGill University, Montréal, Québec, Canada
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Jill Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, Québec, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Simon Gilbody
- Hull York Medical School and the Department of Health Sciences, University of York, Heslington, NY, UK
| | - Lorie A Kloda
- Library, Concordia University, Montréal, Québec, Canada
| | - Dean McMillan
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Ian Shrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sultan H Alamri
- Faculty of Medicine, King Abdulaziz University, Jeddah, Makkah, Saudi Arabia
| | - Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Liat Ayalon
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | - Hamid R Baradaran
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran; Ageing Clinical & Experimental Research Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland, UK
| | - Anna Beraldi
- Kbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen, Klinik für Psychiatrie, Psychotherapie & Psychosomatik, Lehrkrankenhaus der Technischen Universität München, Munich, Germany
| | - Charles N Bernstein
- University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada; Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Arvin Bhana
- Centre for Rural Health, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa; Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Charles H Bombardier
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Gregory Carter
- Centre for Brain and Mental Health Research, University of Newcastle, New South Wales, Australia
| | - Marcos H Chagas
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Dixon Chibanda
- Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe
| | - Kerrie Clover
- Centre for Brain and Mental Health Research, University of Newcastle, New South Wales, Australia
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Crisanto Diez-Quevedo
- Servei de Psiquiatria, Hospital Germans Trias i Pujol, Badalona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Jesse R Fann
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Felix H Fischer
- Department of Psychiatry, McGill University, Montréal, Québec, Canada; Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Leila Gholizadeh
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Lorna J Gibson
- Tropical Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Eric P Green
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | | | - Brian J Hall
- Department of Psychology, Faculty of Social Sciences, Global and Community Mental Health Research Group, University of Macau, Macau Special Administrative Region, China; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily E Haroz
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Khalida Ismail
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London Weston Education Centre, London, UK
| | - Nathalie Jetté
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mohammad E Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Yunxin Kwan
- Department of Psychological Medicine, Tan Tock Seng Hospital, Singapore
| | - Maria Asunción Lara
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. San Lorenzo Huipulco, Tlalpan, México D. F. Mexico
| | - Shen-Ing Liu
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore; Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, Taipei, Taiwan
| | - Sonia R Loureiro
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ruth Ann Marrie
- Departments of Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Laura Marsh
- Baylor College of Medicine, Houston and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Anthony McGuire
- Department of Nursing, St. Joseph's College, Standish, ME, USA
| | - Kumiko Muramatsu
- Department of Clinical Psychology, Graduate School of Niigata Seiryo University, Niigata, Japan
| | - Laura Navarrete
- Department of Epidemiology and Psychosocial Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Flávia L Osório
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil
| | - Inge Petersen
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Angelo Picardi
- Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy
| | - Stephanie L Pugh
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA, USA; American College of Radiology, Philadelphia, PA, USA
| | - Terence J Quinn
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - Alasdair G Rooney
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburg, Edinburgh, Scotland, UK
| | - Eileen H Shinn
- Department of Behavioral Science, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | | | - Lena Spangenberg
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | | | - Martin Taylor-Rowan
- Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, Scotland, UK
| | - Alyna Turner
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Henk C van Weert
- Department of General Practice, Amsterdam Institute for General Practice and Public Health, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - Paul A Vöhringer
- Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile; Millennium Institute for Depression and Personality Research (MIDAP), Ministry of Economy, Macul, Santiago, Chile; Psychiatry Department, Tufts Medical Center, Tufts University, Boston, MA, USA
| | - Lynne I Wagner
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC, USA; Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, USA
| | - Jennifer White
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Kirsty Winkley
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Department of Medicine, McGill University, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada; Department of Psychology, McGill University, Montréal, Québec, Canada; Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada; Biomedical Ethics Unit, McGill University, Montréal, Québec, Canada.
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11
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Wu Y, Levis B, Sun Y, Krishnan A, He C, Riehm KE, Rice DB, Azar M, Yan XW, Neupane D, Bhandari PM, Imran M, Chiovitti MJ, Saadat N, Boruff JT, Cuijpers P, Gilbody S, McMillan D, Ioannidis JPA, Kloda LA, Patten SB, Shrier I, Ziegelstein RC, Henry M, Ismail Z, Loiselle CG, Mitchell ND, Tonelli M, Al-Adawi S, Beraldi A, Braeken APBM, Büel-Drabe N, Bunevicius A, Carter G, Chen CK, Cheung G, Clover K, Conroy RM, Cukor D, da Rocha E Silva CE, Dabscheck E, Daray FM, Douven E, Downing MG, Feinstein A, Ferentinos PP, Fischer FH, Flint AJ, Fujimori M, Gallagher P, Gandy M, Goebel S, Grassi L, Härter M, Jenewein J, Jetté N, Julião M, Kim JM, Kim SW, Kjærgaard M, Köhler S, Loosman WL, Löwe B, Martin-Santos R, Massardo L, Matsuoka Y, Mehnert A, Michopoulos I, Misery L, Navines R, O'Donnell ML, Öztürk A, Peceliuniene J, Pintor L, Ponsford JL, Quinn TJ, Reme SE, Reuter K, Rooney AG, Sánchez-González R, Schwarzbold ML, Senturk Cankorur V, Shaaban J, Sharpe L, Sharpe M, Simard S, Singer S, Stafford L, Stone J, Sultan S, Teixeira AL, Tiringer I, Turner A, Walker J, Walterfang M, Wang LJ, White J, Wong DK, Benedetti A, Thombs BD. Probability of major depression diagnostic classification based on the SCID, CIDI and MINI diagnostic interviews controlling for Hospital Anxiety and Depression Scale - Depression subscale scores: An individual participant data meta-analysis of 73 primary studies. J Psychosom Res 2020; 129:109892. [PMID: 31911325 DOI: 10.1016/j.jpsychores.2019.109892] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Two previous individual participant data meta-analyses (IPDMAs) found that different diagnostic interviews classify different proportions of people as having major depression overall or by symptom levels. We compared the odds of major depression classification across diagnostic interviews among studies that administered the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). METHODS Data accrued for an IPDMA on HADS-D diagnostic accuracy were analysed. We fit binomial generalized linear mixed models to compare odds of major depression classification for the Structured Clinical Interview for DSM (SCID), Composite International Diagnostic Interview (CIDI), and Mini International Neuropsychiatric Interview (MINI), controlling for HADS-D scores and participant characteristics with and without an interaction term between interview and HADS-D scores. RESULTS There were 15,856 participants (1942 [12%] with major depression) from 73 studies, including 15,335 (97%) non-psychiatric medical patients, 164 (1%) partners of medical patients, and 357 (2%) healthy adults. The MINI (27 studies, 7345 participants, 1066 major depression cases) classified participants as having major depression more often than the CIDI (10 studies, 3023 participants, 269 cases) (adjusted odds ratio [aOR] = 1.70 (0.84, 3.43)) and the semi-structured SCID (36 studies, 5488 participants, 607 cases) (aOR = 1.52 (1.01, 2.30)). The odds ratio for major depression classification with the CIDI was less likely to increase as HADS-D scores increased than for the SCID (interaction aOR = 0.92 (0.88, 0.96)). CONCLUSION Compared to the SCID, the MINI may diagnose more participants as having major depression, and the CIDI may be less responsive to symptom severity.
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Affiliation(s)
- Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada; Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Psychology, McGill University, Montréal, QC, Canada
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Xin Wei Yan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Parash Mani Bhandari
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Matthew J Chiovitti
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, QC, Canada
| | - Pim Cuijpers
- EMGO Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Simon Gilbody
- Hull York Medical School and the Department of Health Sciences, University of York, Heslington, York, UK
| | - Dean McMillan
- Hull York Medical School and the Department of Health Sciences, University of York, Heslington, York, UK
| | - John P A Ioannidis
- Department of Clinical, Neuro and Developmental Psychology, Department of Medicine, Department of Health Research and Policy, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, CA, USA
| | | | - Scott B Patten
- Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, AB, Canada; Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada; Cuthbertson & Fischer Chair in Pediatric Mental Health, University of Calgary, Calgary, Canada
| | - Ian Shrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada; Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Melissa Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Zahinoor Ismail
- Hotchkiss Brain Institute & O'Brien Institute for Public Health, Calgary, AB, Canada; Department of Psychiatry, Clinical Neuroscience and Community Health Sciences, University of Calgary, Calgary, AB, Canada; Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Carmen G Loiselle
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Ingram School of Nursing, McGill University, Montréal, QC, Canada; Centre for Nursing Research, Jewish General Hospital, Montréal, QC, Canada; Department of Oncology, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Nicholas D Mitchell
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada; Alberta Health Services, Edmonton, AB, Canada
| | - Marcello Tonelli
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Samir Al-Adawi
- Department of Behavioural Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Oman, Oman
| | - Anna Beraldi
- Psychotherapie und Psychsomatik, kbo Lech-Mangfall-Klinik für Psychatrie, Garmisch-Partenkirchen, Bayern, Germany
| | - Anna P B M Braeken
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands; Faculty of Psychology, Open University of the Netherlands, Heerlen, the Netherlands; Department of Health Services Research, CAPHRI School for Public Health and Primary, Maastricht University, Maastricht, the Netherlands
| | - Natalie Büel-Drabe
- Department of Psychiatry and Psychotherapy, University Hospital Zürich, Zürich, Switzerland
| | - Adomas Bunevicius
- Harvard University, Boston, MA, USA; Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gregory Carter
- University of Newcastle, Australia; Calvary Mater Newcastle, Australia
| | - Chih-Ken Chen
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan; Department of Psychiatry, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan
| | - Gary Cheung
- University of Auckland, Auckland, New Zealand
| | - Kerrie Clover
- Centre for Brain and Mental Health Research, University of Newcastle, NSW, Australia
| | - Ronán M Conroy
- Royal College of Surgeons in Ireland Division of Population Health Sciences, Dublin, Ireland
| | | | - Carlos E da Rocha E Silva
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eli Dabscheck
- The Alfred Hospital, Prahran, VIC, Australia; Monash University, Melbourne, Australia
| | - Federico M Daray
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Institute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Elles Douven
- Alzheimer Center Limburg and School for Mental Health and Neuroscience (MHeNs), Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Marina G Downing
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Monash Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, VIC, Australia
| | - Anthony Feinstein
- University of Toronto, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Panagiotis P Ferentinos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece; Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Felix H Fischer
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Alastair J Flint
- University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Maiko Fujimori
- Section of Psychological Science, Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Milena Gandy
- The Department of Psychology, Macquarie University, Sydney, Australia
| | - Simone Goebel
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Christian-Albrechts University, Kiel, Germany
| | - Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy; Psychiatric Unit, Integrated Department of Mental Health and Addictive Behavior, Health Trust, University Hospital, Ferrara, Italy
| | - Martin Härter
- Department of Medical Psychology, University of Hamburg, Hamburg, Germany
| | - Josef Jenewein
- Clinic Zugersee, Center for Psychiatry and Psychotherapie, Oberwil-Zug, Switzerland; University of Zurich, Zurich, Switzerland
| | - Nathalie Jetté
- Departments of Neurology and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, New York, USA
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | - Jae-Min Kim
- Chonnam National University Medical School, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Republic of Korea
| | - Marie Kjærgaard
- Endocrinology Research Group, Medical Clinic, University Hospital of North Norway, Norway; Department of Internal Medicine, Kolding Hospital, Hospital Lillebaelt, Denmark
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Wim L Loosman
- Onze Lieve vrouw Gasthuis, Amsterdam, the Netherlands
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Loreto Massardo
- Centro de Biología Celular y Biomedicina, Facultad de Medicina y Ciencia, Universidad San Sebastián. Santiago, Chile
| | - Yutaka Matsuoka
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan; Lifestyle Medicine, Cooperative Graduate Program, The Jikei University Graduate School of Medicine, Tokyo, Japan
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Laurent Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - Ricard Navines
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | | | | | - Jurate Peceliuniene
- Clinic of Internal Diseases, Family Medicine and Oncology, Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - Luis Pintor
- Consultation Liaison Psychiatry Unit, Hospital Clínico de Barcelona, Barcelona, Spain; Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Jennie L Ponsford
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Monash Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, VIC, Australia
| | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Silje E Reme
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway; Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Katrin Reuter
- Private Practice for Psychotherapy and Psycho-oncology, Freiburg, Germany
| | - Alasdair G Rooney
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK; Robert Fergusson Unit, Royal Edinburgh Hospital, NHS Lothian, Edinburgh, UK
| | - Roberto Sánchez-González
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Centre Emili Mira, Parc de Salut Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Marcelo L Schwarzbold
- Department of Internal Medicine, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Juwita Shaaban
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Louise Sharpe
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | | | - Sébastien Simard
- Département des sciences de la santé, Université du Québec à Chicoutimi (UQAC), QC, Canada; Centre intersectoriel en santé durable (CISD), QC, Canada; Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ), QC, Canada
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre Mainz, Mainz, Germany
| | - Lesley Stafford
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Jon Stone
- University of Edinburgh, Edinburgh, UK
| | - Serge Sultan
- Université de Montréal, QC, Canada; CHU Sainte-Justine, Montréal, QC, Canada
| | - Antonio L Teixeira
- University of Texas Health Science Center at Houston, Houston, TX, USA; Santa Casa BH Ensino & Pesquisa, Belo Horizonte, Brazil
| | - Istvan Tiringer
- Institute of Behavioral Sciences, Pécs University, Medical School, Pécs, Hungary
| | - Alyna Turner
- IMPACT Strategic Research Centre and School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia; Faculty of Health and Medicine, School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Department of Psychiatry, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | | | - Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia; Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | | | - Dana K Wong
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, QC, Canada; Department of Medicine, McGill University, Montréal, QC, Canada.
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada; Department of Psychiatry, McGill University, Montréal, QC, Canada; Department of Psychology, McGill University, Montréal, QC, Canada; Department of Medicine, McGill University, Montréal, QC, Canada; Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada.
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12
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He C, Levis B, Riehm KE, Saadat N, Levis AW, Azar M, Rice DB, Krishnan A, Wu Y, Sun Y, Imran M, Boruff J, Cuijpers P, Gilbody S, Ioannidis JP, Kloda LA, McMillan D, Patten SB, Shrier I, Ziegelstein RC, Akena DH, Arroll B, Ayalon L, Baradaran HR, Baron M, Beraldi A, Bombardier CH, Butterworth P, Carter G, Chagas MH, Chan JCN, Cholera R, Clover K, Conwell Y, de Man-van Ginkel JM, Fann JR, Fischer FH, Fung D, Gelaye B, Goodyear-Smith F, Greeno CG, Hall BJ, Harrison PA, Härter M, Hegerl U, Hides L, Hobfoll SE, Hudson M, Hyphantis T, Inagaki M, Ismail K, Jetté N, Khamseh ME, Kiely KM, Kwan Y, Lamers F, Liu SI, Lotrakul M, Loureiro SR, Löwe B, Marsh L, McGuire A, Mohd-Sidik S, Munhoz TN, Muramatsu K, Osório FL, Patel V, Pence BW, Persoons P, Picardi A, Reuter K, Rooney AG, Santos IS, Shaaban J, Sidebottom A, Simning A, Stafford L, Sung S, Tan PLL, Turner A, van Weert HC, White J, Whooley MA, Winkley K, Yamada M, Thombs BD, Benedetti A. The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis. Psychother Psychosom 2019; 89:25-37. [PMID: 31593971 PMCID: PMC6960351 DOI: 10.1159/000502294] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/19/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9 diagnostic algorithm. Many primary studies publish results for only one approach, and previous meta-analyses of the algorithm approach included only a subset of primary studies that collected data and could have published results. OBJECTIVE To use an individual participant data meta-analysis to evaluate the accuracy of two PHQ-9 diagnostic algorithms for detecting major depression and compare accuracy between the algorithms and the standard PHQ-9 cutoff score of ≥10. METHODS Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, Web of Science (January 1, 2000, to February 7, 2015). Eligible studies that classified current major depression status using a validated diagnostic interview. RESULTS Data were included for 54 of 72 identified eligible studies (n participants = 16,688, n cases = 2,091). Among studies that used a semi-structured interview, pooled sensitivity and specificity (95% confidence interval) were 0.57 (0.49, 0.64) and 0.95 (0.94, 0.97) for the original algorithm and 0.61 (0.54, 0.68) and 0.95 (0.93, 0.96) for a modified algorithm. Algorithm sensitivity was 0.22-0.24 lower compared to fully structured interviews and 0.06-0.07 lower compared to the Mini International Neuropsychiatric Interview. Specificity was similar across reference standards. For PHQ-9 cutoff of ≥10 compared to semi-structured interviews, sensitivity and specificity (95% confidence interval) were 0.88 (0.82-0.92) and 0.86 (0.82-0.88). CONCLUSIONS The cutoff score approach appears to be a better option than a PHQ-9 algorithm for detecting major depression.
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Affiliation(s)
- Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Kira E. Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Alexander W. Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Danielle B. Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Psychology, McGill University, Montréal, Québec, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Jill Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Simon Gilbody
- Hull York Medical School and the Department of Health Sciences, University of York, Heslington, York, UK
| | - John P.A. Ioannidis
- Department of Medicine, Department of Health Research and Policy, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, California, USA
| | | | - Dean McMillan
- Hull York Medical School and the Department of Health Sciences, University of York, Heslington, York, UK
| | - Scott B. Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Ian Shrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Roy C. Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dickens H. Akena
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Bruce Arroll
- Department of General Practice and Primary Health Care, University of Auckland, New Zealand
| | - Liat Ayalon
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | - Hamid R. Baradaran
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
- Ageing Clinical & Experimental Research Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland, UK
| | - Murray Baron
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Anna Beraldi
- Kbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen, Klinik für Psychiatrie, Psychotherapie & Psychosomatik, Lehrkrankenhaus der Technischen Universität München, Munich, Germany
| | - Charles H. Bombardier
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Peter Butterworth
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, Australia
| | - Gregory Carter
- Centre for Brain and Mental Health Research, University of Newcastle, New South Wales, Australia
| | - Marcos H. Chagas
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Juliana C. N. Chan
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Asia Diabetes Foundation, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Hong Kong Institute of Diabetes and Obesity, Hong Kong Special Administrative Region, China
| | - Rushina Cholera
- Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Kerrie Clover
- Centre for Brain and Mental Health Research, University of Newcastle, New South Wales, Australia
- Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | | | - Jesse R. Fann
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Felix H. Fischer
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Germany
| | - Daniel Fung
- Department of Child & Adolescent Psychiatry, Institute of Mental Health, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Catherine G. Greeno
- School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brian J. Hall
- Global and Community Mental Health Research Group, Department of Psychology, Faculty of Social Sciences, University of Macau, Macau Special Administrative Region, China
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrich Hegerl
- Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-Universität Frankfurt, German Depression Foundation, Frankfurt, Germany
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Stevan E. Hobfoll
- STAR-Stress, Anxiety, and Resilience Consultants, Chicago, Illinois, USA
| | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Thomas Hyphantis
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Masatoshi Inagaki
- Department of Psychiatry, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Khalida Ismail
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London Weston Education Centre, London, UK
| | - Nathalie Jetté
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mohammad E. Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Kim M. Kiely
- School of Psychology, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Yunxin Kwan
- Department of Psychological Medicine, Tan Tock Seng Hospital, Singapore
| | - Femke Lamers
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Shen-Ing Liu
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, Taipei, Taiwan
| | - Manote Lotrakul
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sonia R. Loureiro
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Laura Marsh
- Baylor College of Medicine, Houston and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
| | - Anthony McGuire
- Department of Nursing, St. Joseph's College, Standish, Maine, USA
| | - Sherina Mohd-Sidik
- Cancer Resource & Education Centre, and Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Tiago N. Munhoz
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Kumiko Muramatsu
- Department of Clinical Psychology, Graduate School of Niigata Seiryo University, Niigata, Japan
| | - Flávia L. Osório
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Brian W. Pence
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Philippe Persoons
- Department of Adult Psychiatry, University Hospitals Leuven, Leuven, Belgium
- Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Angelo Picardi
- Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy
| | - Katrin Reuter
- Practice for Psychotherapy and Psycho-oncology, Freiburg, Germany
| | - Alasdair G. Rooney
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburg, Edinburgh, Scotland, UK
| | - Iná S. Santos
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Juwita Shaaban
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | - Adam Simning
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Lesley Stafford
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Sharon Sung
- Department of Child & Adolescent Psychiatry, Institute of Mental Health, Singapore
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | | | - Alyna Turner
- School of Medicine and Public Health, University of Newcastle, New South Wales, Newcastle, Australia
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Henk C. van Weert
- Department of General Practice, Amsterdam Institute for General Practice and Public Health, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | | | - Mary A. Whooley
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- Department of Medicine, Veterans Affairs Medical Center, San Francisco, California, USA
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Kirsty Winkley
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Mitsuhiko Yamada
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Ogawa-Higashi, Kodaira, Tokyo, Japan
| | - Brett D. Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
- Department of Psychology, McGill University, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada
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13
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Ishihara M, Harel D, Levis B, Levis AW, Riehm KE, Saadat N, Azar M, Rice DB, Sanchez TA, Chiovitti MJ, Cuijpers P, Gilbody S, Ioannidis JP, Kloda LA, McMillan D, Patten SB, Shrier I, Arroll B, Bombardier CH, Butterworth P, Carter G, Clover K, Conwell Y, Goodyear-Smith F, Greeno CG, Hambridge J, Harrison PA, Hudson M, Jetté N, Kiely KM, McGuire A, Pence BW, Rooney AG, Sidebottom A, Simning A, Turner A, White J, Whooley MA, Winkley K, Benedetti A, Thombs BD. Shortening self-report mental health symptom measures through optimal test assembly methods: Development and validation of the Patient Health Questionnaire-Depression-4. Depress Anxiety 2019; 36:82-92. [PMID: 30238571 PMCID: PMC6321766 DOI: 10.1002/da.22841] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/29/2018] [Accepted: 09/02/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The objective of this study was to develop and validate a short form of the Patient Health Questionnaire-9 (PHQ-9), a self-report questionnaire for assessing depressive symptomatology, using objective criteria. METHODS Responses on the PHQ-9 were obtained from 7,850 English-speaking participants enrolled in 20 primary diagnostic test accuracy studies. PHQ unidimensionality was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally precise short form for each possible length between one and eight items, including and excluding the ninth item. The final short form was selected based on prespecified validity, reliability, and diagnostic accuracy criteria. RESULTS A four-item short form of the PHQ (PHQ-Dep-4) was selected. The PHQ-Dep-4 had a Cronbach's alpha of 0.805. Sensitivity and specificity of the PHQ-Dep-4 were 0.788 and 0.837, respectively, and were statistically equivalent to the PHQ-9 (sensitivity = 0.761, specificity = 0.866). The correlation of total scores with the full PHQ-9 was high (r = 0.919). CONCLUSION The PHQ-Dep-4 is a valid short form with minimal loss of information of scores when compared to the full-length PHQ-9. Although OTA methods have been used to shorten patient-reported outcome measures based on objective, prespecified criteria, further studies are required to validate this general procedure for broader use in health research. Furthermore, due to unexamined heterogeneity, there is a need to replicate the results of this study in different patient populations.
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Affiliation(s)
- Miyabi Ishihara
- Department of Statistics, University of California Berkeley, Berkeley, California, USA
- PRIISM Applied Statistics Center, New York University, New York, New York, USA
- Department of Applied Statistics, Social Science, and Humanities, New York University, New York, New York, USA
| | - Daphna Harel
- PRIISM Applied Statistics Center, New York University, New York, New York, USA
- Department of Applied Statistics, Social Science, and Humanities, New York University, New York, New York, USA
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Alexander W. Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Kira E. Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Danielle B. Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Psychology, McGill University, Montréal, Québec, Canada
| | - Tatiana A. Sanchez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Matthew J. Chiovitti
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, EMGO Institute, VU University, Amsterdam, The Netherlands
| | - Simon Gilbody
- Hull York Medical School and the Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - John P.A. Ioannidis
- Department of Medicine, Department of Health Research and Policy, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, California, USA
| | | | - Dean McMillan
- Hull York Medical School and the Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Scott B. Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute and O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Ian Shrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Bruce Arroll
- Department of General Practice and Primary Health Care, University of Auckland, New Zealand
| | - Charles H. Bombardier
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Peter Butterworth
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Melbourne, Australia
| | - Gregory Carter
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia
| | - Kerrie Clover
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia
- Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester Medical Center, New York
| | | | - Catherine G. Greeno
- School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - John Hambridge
- Liaison Psychiatry Department, John Hunter Hospital, Newcastle, Australia
| | | | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Nathalie Jetté
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute and O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Kim M. Kiely
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Anthony McGuire
- Department of Nursing, St. Joseph’s College, Standish, Maine, USA
| | - Brian W. Pence
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alasdair G. Rooney
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, Scotland, UK
| | | | - Adam Simning
- School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alyna Turner
- School of Medicine and Public Health, University of Newcastle, New South Wales, Newcastle, Australia
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | | | - Mary A. Whooley
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- Department of Medicine, Veterans Affairs Medical Center, San Francisco, California, USA
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Kirsty Winkley
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada
| | - Brett D. Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
- Department of Psychology, McGill University, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
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14
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Levis B, Benedetti A, Riehm KE, Saadat N, Levis AW, Azar M, Rice DB, Chiovitti MJ, Sanchez TA, Cuijpers P, Gilbody S, Ioannidis JPA, Kloda LA, McMillan D, Patten SB, Shrier I, Steele RJ, Ziegelstein RC, Akena DH, Arroll B, Ayalon L, Baradaran HR, Baron M, Beraldi A, Bombardier CH, Butterworth P, Carter G, Chagas MH, Chan JCN, Cholera R, Chowdhary N, Clover K, Conwell Y, de Man-van Ginkel JM, Delgadillo J, Fann JR, Fischer FH, Fischler B, Fung D, Gelaye B, Goodyear-Smith F, Greeno CG, Hall BJ, Hambridge J, Harrison PA, Hegerl U, Hides L, Hobfoll SE, Hudson M, Hyphantis T, Inagaki M, Isamail K, Jetté N, Khamseh ME, Kiely KM, Lamers F, Liu SI, Lotrakul M, Loureiro SR, Löwe B, Marsh L, McGuire A, Sidik SM, Munhoz TN, Muramatsu K, Osório FL, Patel V, Pence BW, Persoons P, Picardi A, Rooney AG, Santos IS, Shaaban J, Sidebottom A, Simning A, Stafford L, Sung S, Tan PLL, Turner A, van der Feltz-Cornelis CM, van Weert HC, Vöhringer PA, White J, Whooley MA, Winkley K, Yamada M, Zhang Y, Thombs BD. Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews. Br J Psychiatry 2018; 212:377-385. [PMID: 29717691 PMCID: PMC6415695 DOI: 10.1192/bjp.2018.54] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.AimsTo evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics. METHOD Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit. RESULTS A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15-3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98-10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7-15) (OR = 0.96; 95% CI = 0.56-1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26-0.97). CONCLUSIONS The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.Declaration of interestDrs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
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Affiliation(s)
- Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E4, Canada
| | - Andrea Benedetti
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, 5252 boul de Maisonneuve, Office/Workstation # 3D.59, Montréal, QC, H4A 3S5, Canada
| | - Kira E. Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E4, Canada
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E4, Canada
| | - Alexander W. Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E4, Canada
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E4, Canada
| | - Danielle B. Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E4, Canada
| | - Matthew J. Chiovitti
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E4, Canada
| | - Tatiana A. Sanchez
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E4, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
| | - Simon Gilbody
- Mental Health and Addiction Research Group, Department of Health Sciences and Hull York Medical School, University of York, Heslington YO10 5DD, United Kingdom
| | | | - Lorie A. Kloda
- Concordia University, 1455, boul. de Maisonneuve Ouest, FB-802, Montréal, QC, H3G 1M8, Canada
| | - Dean McMillan
- Mental Health and Addiction Research Group, Department of Health Sciences and Hull York Medical School, University of York, Heslington YO10 5DD, United Kingdom
| | - Scott B. Patten
- Department of Community Health Sciences, 3rd Floor, TRW Building, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Ian Shrier
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine Rd, Montréal, QC, H3T 1E2, Canada
| | - Russell J. Steele
- Department of Mathematics and Statistics, McGill University, 805 Rue Sherbrooke O., Montreal, QC, H3A 0B9, Canada
| | - Roy C. Ziegelstein
- Johns Hopkins University School of Medicine, Miller Research Building, 733 N. Broadway, Suite 115, Baltimore, MD, 21205, USA
| | - Dickens H. Akena
- Department of Psychiatry, Makerere University College of Health Sciences, P.O.Box 7062 Kampala, Uganda
| | - Bruce Arroll
- Department of General Practice and Primary Health Care, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Liat Ayalon
- Louis and Gabi Weisfeld School of Social Work, Ramat Gan, Bar Ilan University, 52900, Israel
| | - Hamid R. Baradaran
- Endocrinology and Metabolism Research Institute, Shariati Hospital Complex, North Kargar Avenue, Tehran, 14114-13137, Iran
| | - Murray Baron
- Jewish General Hospital, Suite A 725, 3755 Cote St Catherine Rd, Montréal, QC, H3T 1E2, Canada
| | - Anna Beraldi
- Auenstraße 6, D-82467 Garmisch-Partenkirchen, Germany
| | - Charles H. Bombardier
- Division of Clinical and Neuropsychology, Department of Rehabilitation Medicine, University of Washington, Box 359612, Harborview Medical Center, 325 9th Avenue, Seattle, WA, 98104, USA
| | - Peter Butterworth
- Centre for Mental Health, Level 4, 207 Bouverie St, The University of Melbourne, Victoria 3010, Australia
| | - Gregory Carter
- Locked Bag #7, Hunter Region Mail Centre, NSW 2310, Australia
| | - Marcos H. Chagas
- University of São Paulo, Av. Bandeirantes, 3900, 14048-900-Ribeirão Preto, SP, Brazil
| | - Juliana C. N. Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 9/F Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong
| | - Rushina Cholera
- UNC School of Medicine, Department of Pediatrics, CB# 7593, Chapel Hill, NC, 27599-7593, USA
| | - Neerja Chowdhary
- World Health Organization. Avenue Appia 20, 1211 Genève 27, Switzerland
| | - Kerrie Clover
- Psycho-oncology #51, Calvary Mater Newcastle, Platt St, Waratah NSW 2301, Australia
| | - Yeates Conwell
- University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY, 14642, USA
| | - Janneke M. de Man-van Ginkel
- University Medical Center Utrecht, Internal mail no Str. 6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Jaime Delgadillo
- Clinical Psychology Unit, University of Sheffield, Cathedral Court, Floor F, 1 Vicar Lane, Sheffield, S1 1HD, United Kingdom
| | - Jesse R. Fann
- Department of Psychiatry & Behavioral Sciences, Univerisity of Washington, Box 356560, Seattle, WA 98195
| | - Felix H. Fischer
- Medizinische Klinik mit Schwerpunkt Psychosomatik, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10098 Berlin, Germany
| | | | - Daniel Fung
- Institute of Mental Health, 10 Buangkok View, 539747, Singapore
| | - Bizu Gelaye
- Department of Epidemiology, 677 Huntington Ave, Room 505F, Boston, MA, 02115, USA
| | - Felicity Goodyear-Smith
- Department of General Practice & Primary Health Care, University of Auckland, PB 92019, Auckland, 1142, New Zealand
| | - Catherine G. Greeno
- 2204 Cathedral of Learning, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA, 15260, USA
| | - Brian J. Hall
- Department of Psychology, Faculty of Social Sciences, Humanities and Social Sciences Building E21-3040, University of Macau, E21 Avenida da Universidade, Taipa, Macau, China
| | | | - Patricia A. Harrison
- City of Minneapolis Health Department, 250 S. Fourth St., Room 510, Minneapolis, MN 55415, USA
| | - Ulrich Hegerl
- University of Leipzig, Department of Psychiatry and Psychotherapy, Semmelweisstrasse 10, 04103 Leipzig, Germany
| | - Leanne Hides
- School of Psychology, University of Queensland, St Lucia, Brisbane, Queensland, 4072, Australia
| | - Stevan E. Hobfoll
- 1645 W. Jackson Blvd, Suite 400, Dept of Behavioral Sciences, Rush University Medical Center, Chicago, IL, 60614, USA
| | - Marie Hudson
- Jewish General Hospital and Lady Davis Research Institute, 3755 Côte Ste-Catherine Rd, Room A725, Montréal, QC, H3T 1E2, Canada
| | - Thomas Hyphantis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina 451 10, Greece
| | - Masatoshi Inagaki
- Department of Neuropsychiatry, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Khalida Isamail
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 10 Cutcombe Road, London, SE5 9AF, United Kingdom
| | - Nathalie Jetté
- Department of Clinical Neurosciences, University of Calgary, 1403 29th Street NW, T2N 2T9, Canada
| | - Mohammad E. Khamseh
- Endocrinology and Metabolism Research Institute, Shariati Hospital Complex, North Kargar Avenue, Tehran, 14114-13137, Iran
| | - Kim M. Kiely
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Building 54 Mills Road, ACT 2601, Australia
| | - Femke Lamers
- VU University Medical Center, Department Psychiatry, A.J. Ernststraat 1187, room D2.14, 1081 HL Amsterdam, The Netherlands
| | - Shen-Ing Liu
- Department of Psychiatry, Mackay Memorial Hospital, No. 92, Section 2, Chung-Shan North Rd, Taipei, Taiwan
| | - Manote Lotrakul
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Sonia R. Loureiro
- Rua Tenente Catão Roxo, 2650, CEP 14051-140, Ribeirão Preto, SP, Brazil
| | - Bernd Löwe
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Psychosomatische Medizin und Psychotherapie, Martinistr. 52, Gebäude O25, 20246 Hamburg, Germany
| | - Laura Marsh
- Mental Health Care Line, Michael E DeBakey VA Medical Center, Departments of Psychiatry and Neurology, Baylor College of Medicine, 2002 Holcombe Blvd, Houston, TX, 77030, USA
| | | | - Sherina Mohd Sidik
- Cancer Resource & Education Centre / Department of Psychiatry, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Tiago N. Munhoz
- Depto Medicina Social, Programa Pós-graduação Epidemiologia, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, 3º piso, 96020-220 - Pelotas, RS, Brasil
| | - Kumiko Muramatsu
- Department of Clinical Psychology, Graduate School of Niigata Seiryo University, 1-5939, Suidocho, Chuo-ku, Niigata 951-8121, Japan
| | - Flávia L. Osório
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP. Avenida dos Bandeirantes 3900- 3 andar- alaC. Ribeirão Preto - São Paulo - Brasil - CEP 14049-900
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA 02119, USA
| | - Brian W. Pence
- Department of Epidemiology, UNC-Chapel Hill, McGavran-Greenberg 2103C, CB#7435, 135 Dauer Dr, Chapel Hill NC 27599-7435, USA
| | - Philippe Persoons
- Katholieke Universiteit Leuven, Department of Neurosciences, Research Group Psychiatry, University Psychiatric Center KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Angelo Picardi
- Italian National Institute of Health, Centre for Behavioural Sciences and Mental Health, Viale Regina Elena 299, 00161 Rome, Italy
| | - Alasdair G. Rooney
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital Edinburgh, EH10 5HF, Scotland
| | - Iná S. Santos
- Depto Medicina Social, Programa Pós-graduação Epidemiologia, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, 3º piso 96020-220 - Pelotas, RS, Brasil
| | - Juwita Shaaban
- School of Medical Science, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Abbey Sidebottom
- Allina Health, 800 E 28th Street, MR 15521, Minneapolis, MN 55407-3799, USA
| | - Adam Simning
- Strong Behavioral Health, 300 Crittenden Blvd, Rochester, NY, 14642, USA
| | - Lesley Stafford
- Centre for Women’s Mental Health, The Royal Women’s Hospital, Locked Bag 300, Parkville Victoria 3052, Australia
| | - Sharon Sung
- Office of Clinical Sciences, Duke-NUS Medical School, 20 College Road, Level 6, 169856, Singapore
| | | | - Alyna Turner
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | | | - Henk C. van Weert
- Dpt. General Practice, Academic Medical Centre Amsterdam, Meibergdree 9, 1105 AZ Amsterdam, The Netherlands
| | | | - Jennifer White
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing & Health Sciences, Monash University, Kingston Centre, 400 Warrigal Rd, Cheltenham Victoria 3192, Australia
| | - Mary A. Whooley
- Department of Veterans Affairs Medical Center, 4150 Clement Street (111A1), San Francisco, CA 94121, USA
| | - Kirsty Winkley
- King’s College London & Institute of Psychiatry, Psychology & Neuroscience, Weston Education Centre, London SE5 9RS, UK
| | - Mitsuhiko Yamada
- National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan
| | - Yuying Zhang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 9/F Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong
| | - Brett D. Thombs
- Room 302, Institute of Community and Family Psychiatry, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montréal, QC, H3T 1E4, Canada
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Clover K, Lambert SD, Oldmeadow C, Britton B, King MT, Mitchell AJ, Carter G. PROMIS depression measures perform similarly to legacy measures relative to a structured diagnostic interview for depression in cancer patients. Qual Life Res 2018; 27:1357-1367. [DOI: 10.1007/s11136-018-1803-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2018] [Indexed: 12/18/2022]
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Lambert SD, Clover K, Pallant JF, Britton B, King MT, Mitchell AJ, Carter G. Making Sense of Variations in Prevalence Estimates of Depression in Cancer: A Co-Calibration of Commonly Used Depression Scales Using Rasch Analysis. J Natl Compr Canc Netw 2016; 13:1203-11. [PMID: 26483060 DOI: 10.6004/jnccn.2015.0149] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The use of different depression self-report scales warrants co-calibration studies to establish relationships between scores from 2 or more scales. The goal of this study was to examine variations in measurement across 5 commonly used scales to measure depression among patients with cancer: Hospital Anxiety and Depression Scale-Depression subscale (HADS-D), Centre for Epidemiologic Studies Depression Scale (CES-D), Patient Health Questionnaire-9 (PHQ-9), Beck Depression Inventory-II (BDI-II), and Depression Anxiety and Stress Scale-Depression subscale (DASS-D). METHODS The depression scales were completed by 162 patients with cancer. Participants were also assessed by the major depressive episode module of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Rasch analysis and receiver operating characteristic curves were performed. RESULTS Rasch analysis of the 5 scales indicated that these all measured depression. The HADS and BDI-II had the widest measurement range, whereas the DASS-D had the narrowest range. Co-calibration revealed that the cutoff scores across the scales were not equivalent. The mild cutoff score on the PHQ-9 was easier to meet than the mild cutoff score on the CES-D, BDI-II, and DASS-D. The HADS-D possible cutoff score was equivalent to cutoff scores for major to severe depression on the other scales. Optimal cutoff scores for clinical assessment of depression were in the mild to moderate depression range for most scales. CONCLUSIONS The labels of depression associated with the different scales are not equivalent. Most markedly, the HADS-D possible case cutoff score represents a much higher level of depression than equivalent scores on other scales. Therefore, use of different scales will lead to different estimates of prevalence of depression when used in the same sample.
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Affiliation(s)
- Sylvie D Lambert
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
| | - Kerrie Clover
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom. From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
| | - Julie F Pallant
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
| | - Benjamin Britton
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
| | - Madeleine T King
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
| | - Alex J Mitchell
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
| | - Gregory Carter
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom. From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
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Britton B, Baker A, Clover K, McElduff P, Wratten C, Carter G. Heads Up: a pilot trial of a psychological intervention to improve nutrition in head and neck cancer patients undergoing radiotherapy. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12502] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2016] [Indexed: 11/30/2022]
Affiliation(s)
- B. Britton
- Psycho-Oncology Service; Calvary Mater Newcastle; Waratah NSW Australia
- Priority Research Centre for Translational Neuroscience and Mental Health; University of Newcastle; Callaghan NSW Australia
| | - A. Baker
- School of Medicine and Public Health; University of Newcastle; Callaghan NSW Australia
| | - K. Clover
- Psycho-Oncology Service; Calvary Mater Newcastle; Waratah NSW Australia
| | - P. McElduff
- School of Medicine and Public Health; University of Newcastle; Callaghan NSW Australia
| | - C. Wratten
- Radiation Oncology Department; Calvary Mater Newcastle; Waratah NSW Australia
| | - G. Carter
- Psycho-Oncology Service; Calvary Mater Newcastle; Waratah NSW Australia
- Priority Research Centre for Translational Neuroscience and Mental Health; University of Newcastle; Callaghan NSW Australia
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Rankin NM, Butow PN, Thein T, Robinson T, Shaw JM, Price MA, Clover K, Shaw T, Grimison P. Everybody wants it done but nobody wants to do it: an exploration of the barrier and enablers of critical components towards creating a clinical pathway for anxiety and depression in cancer. BMC Health Serv Res 2015; 15:28. [PMID: 25608947 PMCID: PMC4307637 DOI: 10.1186/s12913-015-0691-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 01/09/2015] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND This study aimed to explore barriers to and enablers for future implementation of a draft clinical pathway for anxiety and depression in cancer patients in the Australian context. METHODS Health professionals reviewed a draft clinical pathway and participated in qualitative interviews about the delivery of psychosocial care in their setting, individual components of the draft pathway, and barriers and enablers for its future implementation. RESULTS Five interrelated themes were identified: ownership; resources and responsibility; education and training; patient reluctance; and integration with health services beyond oncology. CONCLUSIONS The five themes were perceived as both barriers and enablers and provide a basis for an implementation plan that includes strategies to overcome barriers. The next steps are to design and deliver the clinical pathway with specific implementation strategies that address team ownership, endorsement by leaders, education and training modules designed for health professionals and patients and identify ways to integrate the pathway into existing cancer services.
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Affiliation(s)
- Nicole M Rankin
- Translational Research Fellow, Sydney Catalyst, The University of Sydney, Chris O'Brien Lifehouse, Level 6, 119-143 Missenden Road, Camperdown, NSW, 2050, Australia.
| | - Phyllis N Butow
- Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia.
| | - Thida Thein
- Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia.
| | - Tracy Robinson
- Workforce Education and Development Group, Sydney Medical School, The University of Sydney, Sydney, Australia.
| | - Joanne M Shaw
- Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia.
| | - Melanie A Price
- Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia.
| | - Kerrie Clover
- Calvary Mater Newcastle Hospital, Newcastle, Australia.
| | - Tim Shaw
- Workforce Education and Development Group, Sydney Medical School, The University of Sydney, Sydney, Australia.
| | - Peter Grimison
- Chris O'Brien Lifehouse, Missenden Road, Camperdown, NSW, Australia.
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Carter G, Clover K, Britton B, Mitchell AJ, White M, McLeod N, Denham J, Lambert SD. Wellbeing during Active Surveillance for localised prostate cancer: a systematic review of psychological morbidity and quality of life. Cancer Treat Rev 2014; 41:46-60. [PMID: 25467109 DOI: 10.1016/j.ctrv.2014.11.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 10/27/2014] [Accepted: 11/03/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Active Surveillance (AS) is recommended for the treatment of localised prostate cancer; however this option may be under-used, at least in part because of expectations of psychological adverse events in those offered or accepting AS. OBJECTIVE (1) Determine the impact on psychological wellbeing when treated with AS (non-comparative studies). (2) Compare AS with active treatments for the impact on psychological wellbeing (comparative studies). METHOD We used the PRISMA guidelines and searched Medline, PsychInfo, EMBASE, CINHAL, Web of Science, Cochrane Library and Scopus for articles published January 2000-2014. Eligible studies reported original quantitative data on any measures of psychological wellbeing. RESULTS We identified 34 eligible articles (n=12,497 individuals); 24 observational, eight RCTs, and two other interventional studies. Studies came from North America (16), Europe (14) Australia (3) and North America/Europe (1). A minority (5/34) were rated as high quality. Most (26/34) used validated instruments, whilst a substantial minority (14/34) used watchful waiting or no active treatment rather than Active Surveillance. There was modest evidence of no adverse impact on psychological wellbeing associated with Active Surveillance; and no differences in psychological wellbeing compared to active treatments. CONCLUSION Patients can be informed that Active Surveillance involves no greater threat to their psychological wellbeing as part of the informed consent process, and clinicians need not limit access to Active Surveillance based on an expectation of adverse impacts on psychological wellbeing.
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Affiliation(s)
- Gregory Carter
- Centre for Translational Neuroscience and Mental Health, School of Medical Practice and Population Health, Faculty of Health, University of Newcastle, NSW, Australia.
| | - Kerrie Clover
- Psycho-Oncology Service, Calvary Mater Newcastle, School of Psychology, Faculty of Science and Information Technology, Centre for Translational Neuroscience & Mental Health Research, University of Newcastle, Australia
| | - Ben Britton
- Psycho-Oncology Service, Calvary Mater Newcastle, School of Psychology, Faculty of Science and Information Technology, Centre for Translational Neuroscience & Mental Health Research, University of Newcastle, Australia
| | - Alex J Mitchell
- Depart of Cancer & Molecular Medicine, Leicester Royal Infirmary & University of Leicester, Leicester LE5 1WW, United Kingdom
| | - Martin White
- Consultant Urologist, New Lambton, Newcastle, NSW, Australia
| | - Nicholas McLeod
- John Hunter Hospital, New Lambton, Newcastle, NSW, Australia
| | - Jim Denham
- Faculty of Health and Medicine, Prostate Cancer Trials Group, School of Medicine and Public Health, University of Newcastle, NSW, Australia
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Carter GL, Clover K, Whyte IM, Dawson AH, D'Este C. Postcards from the EDge: 5-year outcomes of a randomised controlled trial for hospital-treated self-poisoning. Br J Psychiatry 2013; 202:372-80. [PMID: 23520223 DOI: 10.1192/bjp.bp.112.112664] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Repetition of hospital-treated self-poisoning and admission to psychiatric hospital are both common in individuals who self-poison. AIMS To evaluate efficacy of postcard intervention after 5 years. METHOD A randomised controlled trial of individuals who have self-poisoned: postcard intervention (eight in 12 months) plus treatment as usual v. treatment as usual. Our primary outcomes were self-poisoning admissions and psychiatric admissions (proportions and event rates). RESULTS There was no difference between groups for any repeat-episode self-poisoning admission (intervention group: 24.9%, 95% CI 20.6-29.5; control group: 27.2%, 95% CI 22.8-31.8) but there was a significant reduction in event rates (incidence risk ratio (IRR) = 0.54, 95% CI 0.37-0.81), saving 306 bed days. There was no difference for any psychiatric admission (intervention group: 38.1%, 95% CI 33.1-43.2; control group: 35.5%, 95% CI 30.8-40.5) but there was a significant reduction in event rates (IRR = 0.66, 95% CI 0.47-0.91), saving 2565 bed days. CONCLUSIONS A postcard intervention halved self-poisoning events and reduced psychiatric admissions by a third after 5 years. Substantial savings occurred in general hospital and psychiatric hospital bed days.
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Affiliation(s)
- Gregory L Carter
- Centre for Translational Neuroscience and Mental Health, Faculty of Health, University of Newcastle, Newcastle, Australia.
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Clover K, Kelly P, Rogers K, Britton B, Carter GL. Predictors of desire for help in oncology outpatients reporting pain or distress. Psychooncology 2012; 22:1611-7. [DOI: 10.1002/pon.3188] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 08/20/2012] [Accepted: 08/20/2012] [Indexed: 11/12/2022]
Affiliation(s)
- Kerrie Clover
- Calvary Mater Newcastle, Psycho-Oncology Service; Newcastle; New South Wales; Australia
| | - Pete Kelly
- University of Wollongong; Psychology; Wollongong; New South Wales; Australia
| | - Kerry Rogers
- Calvary Mater Newcastle, Psycho-Oncology Service; Newcastle; New South Wales; Australia
| | - Ben Britton
- Calvary Mater Newcastle, Psycho-Oncology Service; Newcastle; New South Wales; Australia
| | - Gregory Leigh Carter
- Calvary Mater Newcastle, Psycho-Oncology Service; Newcastle; New South Wales; Australia
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Turner A, Hambridge J, White J, Carter G, Clover K, Nelson L, Hackett M. Depression screening in stroke: a comparison of alternative measures with the structured diagnostic interview for the diagnostic and statistical manual of mental disorders, fourth edition (major depressive episode) as criterion standard. Stroke 2012; 43:1000-5. [PMID: 22363064 DOI: 10.1161/strokeaha.111.643296] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Screening tools for depression and psychological distress commonly used in medical settings have not been well validated in stroke populations. We aimed to determine the accuracy of common screening tools for depression or distress in detecting caseness for a major depressive episode compared with a clinician-administered structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition as the gold standard. METHODS Seventy-two participants ≥3 weeks poststroke underwent a diagnostic interview for major depressive episode and completed the Patient Health Questionnaire-2 and -9, Hospital Anxiety and Depression Scale, Beck Depression Inventory-II, Distress Thermometer, and Kessler-10. Internal consistency, sensitivity, specificity, likelihood ratios, and posttest probabilities were calculated. Each measure was validated against the gold standard using receiver operating characteristic curves with comparison of the area under the curve for all measures. RESULTS Internal consistency ranged from acceptable to excellent for all measures (Cronbach α=0.78-0.94). Areas under the curve (95% CI) for the Patient Health Questionnaire-2, Patient Health Questionnaire-9, Hospital Anxiety and Depression Scale depression and total score, Beck Depression Inventory-II, and Kessler-10 ranged from 0.80 (0.69-0.89) for the Kessler-10 to 0.89 (0.79-0.95) for the Beck Depression Inventory-II with no significant differences between measures. The Distress Thermometer had an area under the curve (95% CI) of 0.73 (0.61-0.83), significantly smaller than the Beck Depression Inventory-II (P<0.05). CONCLUSIONS Apart from the Distress Thermometer, selected scales performed adequately in a stroke population with no significant difference between measures. The Patient Health Questionnaire-2 would be the most useful single screen given free availability and the shortest number of items.
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Affiliation(s)
- Alyna Turner
- Senior Research Fellow, Heart Research Centre, Box 2137 Post Office, The Royal Melbourne Hospital, Victoria 3050, Australia.
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Carter G, Britton B, Clover K, Rogers K, Adams C, McElduff P. Effectiveness of QUICATOUCH: a computerised touch screen evaluation for pain and distress in ambulatory oncology patients in Newcastle, Australia. Psychooncology 2011; 21:1149-57. [PMID: 21780241 DOI: 10.1002/pon.2020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 05/10/2011] [Accepted: 05/16/2011] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe the change in pain and distress over time to demonstrate the effectiveness of the QUICATOUCH program in an outpatient oncology population. METHODS Descriptive study of the first 29 months of the QUICATOUCH program (13 736 assessments for 5775 patients). A longitudinal cohort design was used to examine the patients with three or more assessments (8129 assessments for 1778 patients). Effectiveness of this complex intervention (repeated assessment, clinician report and referral to speciality psycho-oncology service) was examined using: reduction in proportion over threshold for pain and distress, predictors of mean pain and distress scores and comparison of the number of new patients treated by the psycho-oncology service during the study and in the preceding 29 months. RESULTS Pain and distress declined during the study. The risk of being over threshold at endpoint was reduced for pain (odds ratio (OR) 0.70, confidence interval (CI) 95% 0.60-0.81) and for distress (OR 0.58 CI 95% 0.49-0.68) with baseline as referent level. Three variables predicted the mean pain: clinic type, current radiotherapy treatment and distress score; and five predicted mean distress: time, gender, clinic type, age and pain score. There was an increase of 40% (533v747) in new patients treated by the psycho-oncology service. CONCLUSIONS The QUICATOUCH assessment for pain and distress was implemented into usual clinical practice with reasonable coverage of patients for modest cost. It was effective in monitoring the patients over time, contributed to a reduction in pain and distress, whilst appropriately increasing the number of new patients reaching psychological treatment as part of the clinical service.
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Affiliation(s)
- Gregory Carter
- Psycho-Oncology Service and Department Consultation-Liaison Psychiatry, Calvary Mater Newcastle, Australia; Centre for Brain and Mental Health, University of Newcastle, NSW, Australia.
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Luckett T, Britton B, Clover K, Rankin NM. Evidence for interventions to improve psychological outcomes in people with head and neck cancer: a systematic review of the literature. Support Care Cancer 2011; 19:871-81. [PMID: 21369722 DOI: 10.1007/s00520-011-1119-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2010] [Accepted: 02/13/2011] [Indexed: 11/29/2022]
Abstract
PURPOSE In addition to cancer-related distress, people with head and neck cancer (HNC) endure facial disfigurement and difficulties with eating and communication. High rates of alcohol use and socio-economic disadvantage raise concerns that patients with HNC may be less likely than others to participate in and adhere to psychological interventions. This article aims to inform future practice and research by reviewing the evidence in support of psychological interventions for this patient group. METHODS We searched CENTRAL, Medline, Embase, PsycINFO and CINAHL in December 2009. Relevant studies were rated for internal and external validity against the criteria of the Agency for Healthcare Research and Quality (AHRQ) US Preventive Services Task Force. Wherever possible, outcomes were evaluated using effect sizes to confirm statistically significant results and enable comparison between studies. Meta-analysis was planned according to criteria in the Cochrane Handbook for Systematic Reviews. Levels of evidence for each intervention type were evaluated using AHRQ criteria. RESULTS Nine studies met inclusion criteria. One study was rated 'good' for internal validity and four for external validity. Psycho-education and/or cognitive-behavioural therapy were evaluated by seven studies, and communication skills training and a support group by one study each. Significant heterogeneity precluded meta-analysis. Based on a study-by-study review, there was most support for psycho-education, with three out of five studies finding at least some effect. CONCLUSIONS Research to date suggests it is feasible to recruit people with HNC to psychological interventions and to evaluate their progress through repeated-outcome measures. Evidence for interventions is limited by the small number of studies, methodological problems, and poor comparability. Future interventions should target HNC patients who screen positive for clinical distress and be integrated into standard care.
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Affiliation(s)
- T Luckett
- Psycho-oncology Co-operative Research Group, The University of Sydney, Sydney, NSW, Australia.
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Jayasekera H, Carter G, Clover K. Comparison of the Composite International Diagnostic interview (CIDI-Auto) with clinical diagnosis in a suicidal population. Arch Suicide Res 2011; 15:43-55. [PMID: 21293999 DOI: 10.1080/13811118.2011.540208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The objective was to examine agreement between routine clinician diagnoses of DSM-IV Anxiety, Depressive, Substance-Use disorders with diagnoses generated by CIDI-Auto Version 2.1, administered by trained interviewers. Subjects were 329 deliberate self poisoning patients at a tertiary referral center in Australia. Tests of agreement were: percentage agreement, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and Cohen's kappa coefficients, for 1 month and 12 month CIDI diagnoses. Agreement was poor (kappa <0.40) for Anxiety, Depressive and Substance-Use disorders. Since diagnosis largely determines subsequent treatment, these findings did not support the use of the less expensive CIDI-Auto procedure to replace clinical diagnosis by experienced clinicians for this group of patients exhibiting suicidal behavior.
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Affiliation(s)
- Himali Jayasekera
- Hunter New England Mental Health Services, Newcastle, NSW, Australia
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Clover K, Oultram S, Adams C, Cross L, Findlay N, Ponman L. Disruption to radiation therapy sessions due to anxiety among patients receiving radiation therapy to the head and neck area can be predicted using patient self-report measures. Psychooncology 2010; 20:1334-41. [PMID: 20878722 DOI: 10.1002/pon.1854] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 06/22/2010] [Accepted: 08/16/2010] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This analysis sought to determine whether patient self-report measures were associated with disruption to radiation therapy sessions due to anxiety among cancer patients undergoing radiation therapy to the head and neck region. METHOD A cohort of patients undergoing radiation therapy to the head and neck region at a major regional radiation oncology treatment centre (ROTC) in Australia completed self-report measures of anxiety, history of panic and fears relevant to use of an immobilising mask. The treating Radiation Therapist (RT) rated the level of session disruption due to patient anxiety during the Computerised Tomography/Simulation (CT/Sim) (baseline) session and first treatment session. RESULTS Complete data were obtained for 90 patients. RTs rated 11 and 24% of patients as having some level of session disruption session due to anxiety at baseline and Treatment 1, respectively. Five factors were significantly associated with session disruption at baseline in bivariate analyses: currently taking psycho-active medication (p=0.008); fear of enclosed spaces (p=0.006); fear of face being covered up (p=0.006); fear of movement restriction (p=0.041) and ever had an anxiety attack (p=0.034). Sensitivity ranged from 0.57 to 0.75 and specificity ranged from 0.68 to 0.90. Only session disruption at baseline predicted disruption at Treatment 1 (p<0.01). CONCLUSIONS This study offers some preliminary insights into the prevalence of patient anxiety severe enough to cause session disruption and patient self-report measures which might be used to flag patients for prophylactic treatment. Further development and replication in a larger sample is warranted before introduction of these measures into routine practice.
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Affiliation(s)
- Kerrie Clover
- Psycho-Oncology Service, Calvary Mater Newcastle, Waratah, NSW, Australia.
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Abstract
OBJECTIVES To determine the health needs of public housing tenants, measured in terms of self-reported health status, health risk factors and expressed need for health risk reduction intervention. METHOD Face-to-face interviews were conducted with a randomly selected sample of public housing tenants in the Hunter Region of New South Wales. RESULTS Of 463 contactable tenants, 329 consented to participate in the study. Participants were 2.5 times more likely to rate their health as fair or poor relative to the community generally, and visited a doctor twice as often. The prevalence of smoking was more than twice that of the community generally, and the prevalence of falls was approximately three times greater. Risk of injury due to domestic violence was approximately six times greater, and the risk of injury due to violence in other locations was more than double that in the community. Between a quarter and a half of the participants requested support to reduce their health risks. CONCLUSIONS The findings suggest that public housing tenants are one of the more severely health-compromised groups in the Australian community. IMPLICATIONS An urgent need exists for public health initiatives that are directed at improving not only the current markedly poorer health status of public housing tenants, but also the greater prevalence of health risk factors that predict a likely continuation of such differentials into the future.
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Affiliation(s)
- J Wiggers
- Hunter Centre for Health Advancement and Faculty of Medicine and Health Sciences, University of Newcastle, New South Wales.
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Clover K, Leigh Carter G, Adams C, Hickie I, Davenport T. Concurrent validity of the PSYCH-6, a very short scale for detecting anxiety and depression, among oncology outpatients. Aust N Z J Psychiatry 2009; 43:682-8. [PMID: 19530026 DOI: 10.1080/00048670902970809] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To improve the acceptability of screening for depression and anxiety among patients with cancer there is a need for scales that are both very short and accurate. To date no very short questionnaire has been found to provide optimal performance for screening in oncology populations and other candidates must be examined. This study examined the concurrent validity of a relatively new, very short scale, the six item PSYCH-6 subscale of the Somatic and Psychological Health Report (SPHERE-12), in an oncology outpatient population. METHODS Cross-sectional survey of 340 oncology outpatients attending a regional hospital in Newcastle, Australia. The performance of the PSYCH-6 against the Hospital Anxiety and Depression Scale (HADS) was evaluated using correlation, Cohen's kappa, positive agreement and negative agreement. RESULTS The PSYCH-6 subscale of the SPHERE-12, at a cut-off point of 3, had substantial agreement with the total score of the HADS (HADS-T; kappa = 0.73, p < 0.001). Negative agreement (0.92) was marginally higher than positive agreement (0.80). CONCLUSIONS The PSYCH-6 scale of the SPHERE-12 at a cut-off point of 3 is an equivalent instrument to the HADS-T for detecting cases and excluding non-cases of anxiety and depression and is suitable for deployment in oncology populations.
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Affiliation(s)
- Kerrie Clover
- Faculty of Health, Psycho-Oncology Service, Calvary Mater, School of Medical Practice and Population Health, University of Newcastle, NSW, Australia.
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Clover K, Carter GL, Mackinnon A, Adams C. Is my patient suffering clinically significant emotional distress? Demonstration of a probabilities approach to evaluating algorithms for screening for distress. Support Care Cancer 2009; 17:1455-62. [DOI: 10.1007/s00520-009-0606-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Accepted: 02/25/2009] [Indexed: 11/28/2022]
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Carter GL, Clover K, Whyte IM, Dawson AH, D'Este C. Postcards from the EDge: 24-month outcomes of a randomised controlled trial for hospital-treated self-poisoning. Br J Psychiatry 2007; 191:548-53. [PMID: 18055960 DOI: 10.1192/bjp.bp.107.038406] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Repetition of self-poisoning is common. AIMS To report the 24-month outcomes of a non-obligatory postcard intervention (plus treatment as usual) compared with treatment as usual. METHOD In a randomised-controlled trial (Zelen design) conducted in Newcastle, Australia, eight postcards were sent to participants over a 12-month period. The principal outcomes were the proportion of participants with one or more repeat episodes of self-poisoning and the number of repeat episodes per person. RESULTS No significant reduction was observed in the proportion of people repeating self-poisoning in the intervention group (21.2%, 95% CI 17.0-25.3) compared with the control group (22.8%, 95% CI 18.7-27.0; chi(2)=0.32, d.f.=1, P=0.57); the difference between groups was -1.7% (95% CI -7.5 to 4.2). There was a significant reduction in the rate of repetition, with an incidence risk ratio of 0.49 (95% CI 0.33-0.73). CONCLUSIONS A postcard intervention maintained the halving of the rate of repetition of hospital-treated self-poisoning events over a 2-year period, although it did not significantly reduce the proportion of individuals who repeated self-poisoning.
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Affiliation(s)
- Gregory L Carter
- Department of Consultation-Liaison Psychiatry, Locked Bag 7, Hunter Region Mail Centre, NSW 2310, Australia.
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Abstract
Modifiable risk factors for suicide attempt require identification in clinical and community samples. The aim of this study was to determine if similar social and psychiatric factors are associated with suicide attempts in community and clinical settings and whether the magnitude of effect is greater in clinical populations. Two case-control studies were used: nationwide community-based lifetime attempted suicide (ComAS) cases compared to nationwide community controls; and clinical deliberate self-poisoning (ClinDSP) cases that had hospital treatment compared to normative controls of similar demographic composition. The pattern of risk factors in ComAS and ClinDSP cases was similar, the magnitude of risk usually greater in clinical cases. Greatest attributable fractions were: ComAS current unemployment (39.8% male, 15.5% female) and anxiety disorders (14.0% males, 22.6% females); and ClinDSP current unemployment (69.6% male, 55.5% female) and affective disorders (45.4% male, 39.1% female). Practical intervention targets were unemployment, anxiety and substance use disorders, affective disorders (clinical only), and personality disorder (females only).
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Affiliation(s)
- Gregory L Carter
- Suicide Prevention Research Unit, Centre for mental Health Studies, Newcastle Mater Miseriocordae Hospital, Warath, NSW 2298, Australia.
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Abstract
OBJECTIVES To examine the feasibility of a computerised assessment and to compare resulting quality of life scores among oncology carers and patients. METHODS Six hundred and twenty-two subjects (carers n = 234, patients n = 388) attending an oncology or haematology clinic completed the WHO-Quality of Life-BREF (WHOQOL-BREF) and demographics on a personal computer. Age- and gender-standardised scores for carers and patients were compared to community norms. Carers were compared with patients using six three-way ANOVAs. RESULTS In total, 60.3% (234/388) of the patients had an accompanying carer attempt the survey and 93.6% (219 of 234) completed all items. The four domains of the WHOQOL-BREF had acceptable internal consistency (Cronbach alpha coefficients). Carers had lower quality of life on three domains (physical, psychological and environmental), and patients on two domains (physical and psychological), compared with the general community. Carers had higher overall satisfaction with their health than patients (standardised difference of 0.52 units-moderate effect). CONCLUSION A computerised system for assessing quality of life was feasible and found that carers and patients had significant impairments in quality of life. Clinicians and services interested in quality of life for carers and patients may use computerised assessments to identify those with poorer quality of life.
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Affiliation(s)
- Gregory Carter
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, NSW, Australia.
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Carter GL, Clover K, Whyte IM, Dawson AH, D'Este C. Postcards from the EDge project: randomised controlled trial of an intervention using postcards to reduce repetition of hospital treated deliberate self poisoning. BMJ 2005; 331:805. [PMID: 16183654 PMCID: PMC1246077 DOI: 10.1136/bmj.38579.455266.e0] [Citation(s) in RCA: 174] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2005] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine whether an intervention using postcards (postcards from the EDge project) reduces repetitions of hospital treated deliberate self poisoning. DESIGN Randomised controlled trial. SETTING Regional referral service for general hospital treated deliberate self poisoning in Newcastle, Australia. PARTICIPANTS 772 patients aged over 16 years with deliberate self poisoning. INTERVENTION Non-obligatory intervention using eight postcards over 12 months along with standard treatment compared with standard treatment alone. MAIN OUTCOME MEASURES Proportion of patients with one or more repeat episodes of deliberate self poisoning and the number of repeat episodes for deliberate self poisoning per person in 12 months. RESULTS The proportion of repeaters with deliberate self poisoning in the intervention group did not differ significantly from that in the control group (57/378, 15.1%, 95% confidence interval 11.5% to 18.7% v 68/394, 17.3%, 13.5% to 21.0%: difference between groups -2%, -7% to 3%). In unadjusted analysis the number of repetitions were significantly reduced (incidence risk ratio 0.55, 0.35 to 0.87). CONCLUSION A postcard intervention reduced repetitions of deliberate self poisoning, although it did not significantly reduce the proportion of individual repeaters.
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Affiliation(s)
- Gregory L Carter
- Suicide Prevention Research Unit, Centre for Mental Health Studies, Faculty of Health, University of Newcastle, Newcastle, Australia.
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Abstract
This study explored posttraumatic stress disorder (PTSD) among suicide attempters. Participants were 330 hospital-treated deliberate self-poisoning (DSP) patients. Twelve-month prevalence of PTSD and comorbid psychiatric disorders was determined using the Composite International Diagnostic Interview (CIDI-A). Standard disability measures and demographic information were also obtained. PTSD prevalence was 32% among women and 15% among men. The PTSD group had significantly higher levels of affective disorder, anxiety disorders other than PTSD, psychiatric disability, and service utilization than DSP patients without PTSD. Logistic regression modeling showed that PTSD was associated with the type of traumatic event, number of events, affective disorder, and anxiety disorder other than PTSD.
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Affiliation(s)
- Kerrie Clover
- Consultation-Liaison Psychiatry, Newcastle Mater Hospital, Newcastle, Australia.
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Hensley MJ, Chalmers A, Clover K, Gibson PG, Toneguzzi R, Lewis PR. Symptoms of asthma: comparison of a parent-completed retrospective questionnaire with a prospective daily symptom diary. Pediatr Pulmonol 2003; 36:509-13. [PMID: 14618643 DOI: 10.1002/ppul.10360] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In a study of the effects of indoor air pollution on the respiratory health of children in Newcastle, Australia, parental reports of symptoms experienced by children over the previous 12 months were compared with a prospective record of symptoms of cough and wheeze. Parents of 390 children aged 8-11 years completed a questionnaire about child and family respiratory health, which was used to assign children to one of four symptom groups: Wheeze (two or more attacks of wheezing in the last 12 months), Chest-Colds (two or more chest-colds in the last 12 months without wheezing), Cough Alone (a dry cough at night, without a cold or chest infection, that lasted for more than 2 weeks), or Control (none). A balanced sample of children (n=139) was invited to participate further by completing lung function tests, atopy testing, and keeping a daily diary of peak expiratory flow (PEF) and symptoms of cough and wheeze over a 7-week period. Valid data for the daily diary were provided by 66/85 (77.6%) of participants who commenced this stage (47.5% of the 139 invited to participate). The Wheeze group reported significantly more subsequent wheeze (median 16.8% of days) than the other three groups (median 0% of days). Parent reports of asthma-like symptoms over the previous 12 months were consistent with the subsequent experience of symptoms recorded in a daily diary.
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Affiliation(s)
- M J Hensley
- School of Medical Practice and Population Health, University of Newcastle, Division of Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
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Abstract
OBJECTIVE This study (i) explores differences between a clinical sample of deliberate self-poisoning (DSP) patients and a community sample who reported previous attempted suicide (AS); and (ii) examines correlates of suicidal behaviour in these groups compared with a community control group (CC) with no suicidal behaviour. METHOD The study design was: case-case, case-control and cross-sectional population studies. A clinical sample of DSP (n = 51), a community sample of AS (n = 31) and a community sample with no suicidal behaviour (n = 842) were used, all aged 18-24 years. The DSP and AS groups were compared on several variables and two logistic regression models were developed for risk of (i) DSP and (ii) AS compared to community controls. RESULTS The adjusted odds ratios for DSP were: female gender (OR = 5.7, CI = 1.7-19.4), anxiety (OR = 7.4, CI = 2.2-25.1), affective (OR = 23.0, CI = 6.9-76.5), or substance-use disorder (OR = 19.2, CI = 5.6-65.4) and greater mental health related disability (OR = 0.5, CI = 0.3-0.7 for 1 SD decrease). For AS the results were: anxiety (OR = 9.4, CI = 1.7-52.8) or substance-use disorder (OR = 3.0, CI = 1.1-8.7) and greater mental health disability (OR = 0.5, CI = 0.4-0.7). Affective disorder was close to significant for the AS group (OR = 4.0, CI = 0.9-17.1). CONCLUSIONS Correlates of DSP/AS were usually more powerful in the clinical group, but showed a similar pattern of psychiatric disorder and disability factors in both groups, supporting a continuum of risk factors across these groups. Interventions based on modifiable risk factors could target the same factors for public health, primary care or hospital populations: anxiety, depression and substance use disorders and mental health related disability.
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Affiliation(s)
- Gregory L Carter
- Faculty of Health, University of Newcastle, Newcastle, Australia.
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Abstract
Dentists are a potentially valuable source of community education about the health effects surrounding tobacco use. The aims of this study were to provide Australian data on dentists' current practice regarding discussing smoking with patients, dentists' perceptions of the barriers to discussing smoking with patients and dentists' interest in discussing smoking with patients. A postal survey of all dentists who were members of the Hunter Branch of the Australian Dental Association in New South Wales was conducted. Dentists generally reported quite high levels of current activity regarding smoking. The majority of dentists reported asking at least some of their patients whether or not they smoked. Dentists reported that they discussed the possible oral effects of smoking with at least some of their smoking patients. Furthermore, they told at least some of their patients with smoking related disease that smoking may have contributed to their problems. Dentists identified a number of difficulties involved in helping patients quit smoking. These findings may be used to help guide future research and practice in involving dentists further in discussing smoking with patients.
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Affiliation(s)
- K Clover
- Hunter Centre for Health Advancement, Wallsend, NSW
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Clover K, Smyth T, Sanson-Fisher R, Sprogis A. General practitioner perceptions of surgical waiting times. J Qual Clin Pract 1996; 16:195-202. [PMID: 9010819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study explored general practitioners' (GP) perceptions of waiting times and the importance of these perceptions in choosing a surgeon. A randomly selected sample of GPs in the Hunter Area of New South Wales, Australia, provided information prospectively on patients referred to a surgeon. The results indicated that GPs feel a lack of private health insurance makes only a small difference in waiting time to see a surgeon but a large difference in the waiting time for an operation. Additionally, GPs consider that sizeable numbers of patients will wait longer than they consider reasonable for surgical consultations and procedures. However, perceptions of waiting times do not appear to have a major influence on the choice of surgeon.
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Affiliation(s)
- K Clover
- Hunter Centre for Health Advancement, Hunter Area Health Service, Wallsend, NSW, Australia
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Abstract
BACKGROUND If mammographic screening is to reduce mortality from breast cancer, it is essential that a high proportion of the target population attend for screening. In order to achieve this, effective recruitment strategies are needed. This paper reports two trials of recruitment strategies for mammographic screening involving eight communities in rural New South Wales (NSW), Australia. METHODS Each trial involved two matched pairs of towns in the Hunter Valley region of NSW. Towns were randomly allocated to intervention, receiving either mass media promotion or community participation in Trial 1 and community participation or family physician involvement in Trial 2. RESULTS In Trial 1, significantly higher attendance rates were observed in the two towns that received the community participation intervention compared with their matched media promotion towns (63% vs 34%, P < 0.001 and 51% vs 34%, P < 0.01). In Trial 2, a significantly higher attendance rate was observed in one town that received the family physician involvement intervention compared with its matched town which received the community participation intervention (68% vs 51%, P < 0.01). There was no significant difference in attendance in the other pair of towns (68% vs 58%, P = 0.11). CONCLUSIONS Both community participation and family practitioner involvement are more promising strategies for the promotion of attendance at mammographic screening facilities than media promotion alone.
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Affiliation(s)
- K Clover
- Faculty of Medicine and Health Sciences, University of Newcastle, Callaghan NSW, Australia
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Abstract
Compliance is commonly defined as the extent to which a person's behavior coincides with medical or health advice. There is evidence that noncompliance is a common problem with many medications, including antihypertensive treatment. Since noncompliance can have serious adverse effects on patient health it is important that practitioners make use of available strategies for increasing compliance. This paper considers aspects of the literature concerning noncompliance with antihypertensive medications and presents a number of strategies that practitioners can use to increase compliance. These include strategies for increasing patient recall of information and for implementing reminder systems. There is some evidence that eliciting social support can aid compliance as can presenting information about side effects. The importance of prescribing the simplest possible dosage regimen is emphasized.
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Affiliation(s)
- R W Sanson-Fisher
- Faculty of Medicine and Health Sciences, University of Newcastle, New South Wales, Australia
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Abstract
To establish the relative importance of light and food in the control of core temperature (Tc) rhythm in food-restricted hamsters, mature female hamsters maintained in 14L:10D lighting were fed restricted amounts of food at the onset of light (n = 6) or at the onset of dark (n = 6) and were compared to ad lib-fed animals. After 21-25 days of this entrainment, light stimulus was shifted by 12 h, and animals were kept in shifted lighting for another 13 days. Food restriction led to a 0.6 degree decrease in the mean Tc, which was expressed entirely during the day in night-fed hamsters and was evenly divided between day and night in day-fed animals. Thus, Tc and general activity rhythms maintained the entrainment to light under both dietary conditions, with peak values for all occurring during the early night. During 13 days following the 12-h shift in lighting, Tc and activity rhythms shifted in all animals, regardless of nutritional status, from entrainment to preceding lighting, through double rhythm frequency, indicating entrainment to preceding as well as current lighting, to entrainment to current lighting. Thus, in food-restricted hamsters, light stimulus rather than predictable timing of food prevails as the entrainer of Tc and activity rhythms.
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Affiliation(s)
- K T Borer
- Division of Kinesiology, University of Michigan, Ann Arbor 48109
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Cockburn J, De Luise T, Hurley S, Clover K. Development and validation of the PCQ: a questionnaire to measure the psychological consequences of screening mammography. Soc Sci Med 1992; 34:1129-34. [PMID: 1641674 DOI: 10.1016/0277-9536(92)90286-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We have developed a reliable and valid questionnaire to measure the psychological consequences of screening mammography. The questionnaire measures the effect of screening on an individual's functioning on emotional, social, and physical life domains. Content validity was ensured by extensive review of the relevant literature, discussion with professionals and interviews with attenders at a pilot Breast X-ray Screening Program in Melbourne, Australia. Discriminant validity was assessed by having expert judges sort items into dimensions which they appeared to be measuring. Acceptable levels of concordance (above 80%) with a priori classifications were found. Concurrent validity was demonstrated by comparison of subscale scores of 53 attenders at the Breast X-ray Program with an independent interview assessment of dysfunction on each of the emotional, social and physical dimensions. There was over 79% agreement between interview scores and questionnaire scores for each dimension. Construct validity was confirmed by showing that subscale scores varied in predicted ways. For women who were recalled for further investigation, scores on each subscale measuring negative consequences, were higher at the recall clinic than at screening clinic (emotional: t = -7.28; df = 70; P less than 0.001; physical: t = -2.53; df = 70; P = 0.014; social: t = -2.49; df = 70; P = 0.015). The internal consistency of all subscales was found to be acceptable. This questionnaire is potentially useful for assessing the psychological consequences of the screening process and should have wide application.
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Affiliation(s)
- J Cockburn
- Centre for Behavioural Research in Cancer, Anti-Cancer Council of Victoria, Australia
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