Mental disorder screening on cancer patients before and after radiotherapy and at the 1-month follow-up.

Abstract

The aim was to study the accuracy of different screening tests to detect psychopathological disorders in cancer patients treated with radiotherapy before (T1) and after radiotherapy (T2), and at the 1-month follow-up (T3). The Mini International Neuropsychiatric Interview (MINI), the Hospital Anxiety and Depression Scale (HADS), and the distress thermometer (DT) (0-10) were administered, together with a depression scale (DEPQ) (1-5), an anxiety scale (ANSQ) (1-5), and a physical symptoms questionnaire, to patients treated with radiotherapy at T1 (232 participants), T2 (130 participants), and T3 (130 participants). The accuracy of the screening tests was higher at T2, with the HADS-T test (cut-off ≥10) yielding the best results: sensitivity=0.80, specificity=0.92, with an excellent AUC (0.91). The DT test (cut-off ≥4) showed a sensitivity=0.66, a specificity=0.91, and an AUC=0.825, and the DEPQ (cut-off >1) yielded a sensitivity=0.74, a specificity=0.78, and an AUC=0.776. The ANSQ (cut-off >1) showed a sensitivity=0.60, a specificity=0.97, and an AUC=0.831. At T1 and T3, the sensitivity tests were unsatisfactory. The increase in sensitivity at T2 may be due to an increase of physical symptoms at such time, which occurred more frequently in those patients who scored higher on screening tests and showed mental disorders. The diagnostic accuracy of the screening tests was higher at T2. At this time, HADS-T proved to be a good screening instrument; whereas at T1 and T3, screening instruments were only useful to detect cases without mental disorders, but not to identify those who suffer from them.