An analysis of the validity of the Hospital Anxiety and Depression scale as a screening tool in patients with advanced metastatic cancer

被引:98
作者
Lloyd-Williams, M
Friedman, T
Rudd, N
机构
[1] Leicestershire Hospice, Palliat Med Serv, Leicester LE3 9QE, Leics, England
[2] Leicester Gen Hosp, Dept Liaison Psychiat, Leicester LE5 4PW, Leics, England
[3] LOROS Hospice, Palliat Med Serv, Leicester, Leics, England
关键词
depression; palliative care; Hospital Anxiety and Depression scale; psychiatry; hospice;
D O I
10.1016/S0885-3924(01)00358-X
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Depression is difficult to diagnose in the terminally ill patient. As a result, it frequently is not treated. This has can have an adverse effect on quality of life and make the palliation of physical symptoms mare difficult. In an effort to improve the detection of depression, many palliative care teams are using the Hospital Anxiety and Depression (HAD) scale as a screening tool. The HAD was devised for use in general medical settings and has not been validated for use in palliative care patients. One hundred patients receiving palliative cape with an estimated prognosis of 6 months or less were invited to complete the HAD and a semistructured psychiatric interview, the Present State Examination. The depression and anxiety subscales of the HAD showed poor efficacy for screening when used alone. The optimum threshold was at a combined cut-off of 19, which had a sensitivity of 68% and specificity of 67%. The major construct of the HAD is anhedonia, which may be present at the end of life due to increasing physical illness and may not be pathognomic of a depressive illness in this population.. We recommend, therefore, that if the HAD is used as a screening tool in palliative care, it should be as a combined scale, but low sensitivity and specificity may lead to poor efficacy as a screening tool. (C) U.S. Cancer Pain Relief Committee, 2001.
引用
收藏
页码:990 / 996
页数:7
相关论文
共 36 条
[1]  
[Anonymous], CANC EMOTION
[2]  
Brandberg Y, 1992, PSYCHO-ONCOLOGY, V1, P71, DOI DOI 10.1002/PON.2960010204
[3]  
BRUGHA TS, 1993, BRIT J HOSP MED, V50, P175
[4]   SCREENING FOR DEPRESSION AND ANXIETY IN CANCER-PATIENTS USING THE HOSPITAL ANXIETY AND DEPRESSIONS SCALE [J].
CARROLL, BT ;
KATHOL, RG ;
NOYES, R ;
WALD, TG ;
CLAMON, GH .
GENERAL HOSPITAL PSYCHIATRY, 1993, 15 (02) :69-74
[5]  
CASEY P, 1994, PROG PALLIAT CARE, V2, P1
[6]   CONCORDANCE OF DEPRESSION AND ANXIETY IN PATIENTS WITH CANCER [J].
CASSILETH, BR ;
LUSK, EJ ;
HUTTER, R ;
STROUSE, TB ;
BROWN, LL .
PSYCHOLOGICAL REPORTS, 1984, 54 (02) :588-590
[7]  
CHOCHINOV HM, 1994, AM J PSYCHIAT, V151, P537
[8]  
ENDICOTT J, 1984, CANCER, V53, P2243
[9]   SCREENING FOR PSYCHIATRIC MORBIDITY IN PATIENTS WITH ADVANCED BREAST-CANCER - VALIDATION OF 2 SELF-REPORT QUESTIONNAIRES [J].
HOPWOOD, P ;
HOWELL, A ;
MAGUIRE, P .
BRITISH JOURNAL OF CANCER, 1991, 64 (02) :353-356
[10]   PSYCHIATRIC MORBIDITY IN PATIENTS WITH ADVANCED CANCER OF THE BREAST - PREVALENCE MEASURED BY 2 SELF-RATING QUESTIONNAIRES [J].
HOPWOOD, P ;
HOWELL, A ;
MAGUIRE, P .
BRITISH JOURNAL OF CANCER, 1991, 64 (02) :349-352