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Depression Screening

By Lisa Schulmeister, RN, MN, APRN-BC, OCN, FAAN
Screening for depression while patients undergo cancer treatment is an essential component of care. Unfortunately, many of the tools that have been found to be reliable and valid are lengthy.
William Small Jr., MD, chair of the Department of Radiation Oncology at Loyola University in Chicago, evaluated the effectiveness of a two question survey in screening for depression, and presented his findings on September 23, 2013 at the American Society for Radiation Oncology 55th Annual Meeting.

The Patient Health Questionaire-2 (PHQ-2) was evaluated along with other screening tools for depression in 455 patients undergoing or about to undergo radiotherapy at 37 centers in the United States. The questionnaires included the single-question National Comprehensive Cancer Network-Distress Thermometer (NCCN-DT), the Hopkins Symptom Checklist (HSCL-25), and the 9-item Patient Health Questionnaire (PHQ-9). The first 2 questions of the PHQ-9 comprise the PHQ-2. The PHQ-2 asks how often, in the past 2 weeks, the patient has felt "little interest or pleasure in doing things," and how often the patient has felt "down, depressed, or hopeless." The patients are given a score based on the frequency of their feelings. Of the 455 study patients, 75 (16%) screened positive for depressive symptoms and were considered at risk for depression. With the PHQ-9, 41 patients screened positive; with the PHQ-2, 36 did. Patients who screened positive for symptoms of depression, 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 PHQ-2 and PHQ-9 demonstrated equally robust psychometric properties for identifying a major depressive episode. Both of these measures were superior to the HLSC-25 and the NCCN-DT. The researchers concluded that the PHQ-2 may be a simple, time efficient way of screening patients for depression.
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