Northwestern University Feinberg School of Medicine
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Two-Question Survey Effectively Screens Cancer Patients for Depression

Cancer patients receiving radiotherapy (RT) can be effectively screened for depression using a simple, easily administered two-item questionnaire, according to a study presented at the 55th Annual Meeting of the American Society for Radiation Oncology (ASTRO) in September.

Lynne Wagner, PhD, Associate Professor in the Department of Medical Social Sciences at the Feinberg School of Medicine and a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, is Principal Investigator of the Radiation Therapy Oncology Group (RTOG) Community Clinical Oncology Program (CCOP) study.

455 patients receiving radiation treatment at 37 centers around the U.S. were screened for depression before or within two weeks of treatment. The screening forms included the single-item National Comprehensive Cancer Network-Distress Thermometer (NCCN-DT); the Hopkins Symptom Checklist (HSCL-25); and the nine-item Patient Health Questionnaire, (PHQ-9), which includes Patient Health Questionnaire-2 (PHQ-2) as its first two questions. All of the study participants answered the screening questionnaires with 100 percent completion.

Patients received the PHQ-9 and were asked if, within the past two weeks, they had “little interest or pleasure in doing things,” or “if they were feeling down, depressed or hopeless.” It was discovered that patients’ responses to these two questions (the PHQ-2) were as useful in identifying depression as results from the entire PHQ-9, and were more indicative than results from the NCCN-DT.

Of the facilities included in the study, 68 percent offer mental health services. Patients who screened positive for depression symptoms, along with a systematic sample of patients who screened negative, were administered the Structured Clinical Interview for DSM-IV (SCID) Mood Disorder modules by telephone. The study determined that screening in an RT setting was well-received by patients and practicable.

“This study was designed to test the feasibility of screening for major depression in cancer patients receiving radiation therapy. The ability of a two-question survey to effectively screen for depression will hopefully prompt more centers to screen and to refer patients in need of mental health services,” said Wagner. “Detection of depression in cancer patients is an important public health priority, and the ability to screen and treat cancer patients for depression can have a major impact on a patient’s quality of life,” said William Small Jr., MD, FASTRO, Co-Principal Investigator and Chairman of the Department of Radiation Oncology at Loyola University Medical Center.

The study, titled “Two-Item Questionnaire Effectively Screens for Depression in Cancer Patients Receiving Radiotherapy,” was supported by the Radiation Oncology Therapy Group Community Clinical Oncology Program, with funding from the National Institutes of Health.

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