Comparison of the Distress Thermometer, Hospital Anxiety and Depression Scale, Depression and Somatic Symptom Scale for Screening Psychiatric Disorders in Hospitalized Cancer Patients

Purpose: This study assesses the sensitivity and specificity of the distress thermometer (DT), the hospital anxiety and the depression scale (HADS), and depression and somatic symptoms scale (DSSS) for screening psychiatric disorders in hospitalized cancer patients by comparing with the clinical interview. Methods: DT, HADS, and DSSS were evaluated in 160 hospitalized cancer patients prior to the psychiatric interview. Each scale was tested against clinical psychiatric diagnoses based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition for sensitivity and specificity. Results: The receiver operating characteristic (ROC) analysis identified a DT score of 5 as the optimal cut-off point versus clinical psychiatric diagnoses, with sensitivity and specificity of 77% and 100%, respectively. The area under the ROC curve (AUC=0.93) was the largest for DT. HADS and DSSS have similar AUC (0.84 vs 0.84, p=0.90). Among all subscales, the DSSS-depression scale had an AUC of 0.86, which yielded a sensitivity and specificity of 82% and 80%, respectively. Conclusion: DT, DSSS, and HADS had acceptable screening efficacy for psychiatric disorders in cancer patients. We recommend the use of DT and DSSS as an optimal two-step psychiatric screening tool in cancer patients. More studies are needed to verify the value of DSSS in evaluating the treatment response of cancer patients comorbid with psychiatric diagnosis.