Abstract
BackgroundWe have previously reported on the development of a cancer-specific screening instrument for anxiety and depression (PSSCAN). No information on cut-off scores or their meaning for diagnosis was available when PSSCAN was first described. Needed were additional analyses to recommend empirically justified cut-off scores as well as data norms for healthy adult samples so as to lend meaning to the recommended cut-off scores.MethodsWe computed sensitivity/specificity indices based on a sample of 101 cancer patients who had provided PSSCAN data on anxiety and depression and who had completed another standardized instrument with strong psychometrics. Next, we compared mean scores for four samples with known differences in health status, a healthy community sample (n = 561), a sample of patients with a representative mix of cancer subtypes (n = 570), a more severely ill sample of in-patients with cancer (n = 78), and a community sample with a chronic illness other than cancer (n = 85).ResultsSensitivity/specificity analyses revealed that an excellent balance of sensitivity/specificity was achievable with 92%/98% respectively for clinical anxiety and 100% and 86% respectively for clinical depression. Newly diagnosed patients with cancer were no more anxious than healthy community controls but showed elevations in depression scores. Both, patients with chronic illness other than cancer and those with longer-standing cancer diagnoses revealed greater levels of distress than newly diagnosed cancer patients or healthy adult controls.ConclusionThese additional data on criterion validity and community versus patient norms for PSSCAN serve to enhance its utility for clinical practice.
Highlights
We have previously reported on the development of a cancer-specific screening instrument for anxiety and depression (PSSCAN)
Complete data were available from 101 cancer patients with a mean age of 53 years, composed of 60 women and 41 men
Means and standard deviations for all four samples are displayed in Table 2 allowing the comparison of anxiety and depression scores for four groups of people, one cancer outpatients, another one a group of inpatients with more advanced cancer, one large group of healthy community members, and another comparison group of community members with a chronic disease other than cancer
Summary
We have previously reported on the development of a cancer-specific screening instrument for anxiety and depression (PSSCAN). There is steadily growing interest in routine screening for emotional distress in cancer and other medical patients in order to identify patients who need psychological support most urgently [1]. Distress-reducing treatments have been effective only when pre-treatment distress was clearly elevated before treatment initiation [5]. Ignoring this principle translates into a waste of valuable therapy resources that already-strained health care systems can hardly afford. These reasons have led to the development of screening tools for distress
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