Sensitivity and specificity of the Distress Thermometer for depression in newly diagnosed breast cancer patients
Article first published online: 23 OCT 2007
Copyright © 2007 John Wiley & Sons, Ltd.
Volume 17, Issue 6, pages 556–560, June 2008
How to Cite
Hegel, M. T., Collins, E. D., Kearing, S., Gillock, K. L., Moore, C. P. and Ahles, T. A. (2008), Sensitivity and specificity of the Distress Thermometer for depression in newly diagnosed breast cancer patients. Psycho-Oncology, 17: 556–560. doi: 10.1002/pon.1289
- Issue published online: 16 JUN 2008
- Article first published online: 23 OCT 2007
- Manuscript Accepted: 29 AUG 2007
- Manuscript Revised: 21 AUG 2007
- Manuscript Received: 27 MAR 2007
- Norris Cotton Cancer Center. Grant Number: P30CA23108
- Foundation for Informed Medical Decision Making
- medical oncology;
- breast neoplasms;
- sensitivity and specificity;
- psychological tests
Background: Receiving a new diagnosis of breast cancer is a distressing experience that may precipitate an episode of major depressive disorder. Efficient screening methods for detecting depression in the oncology setting are needed. This study evaluated the receiver operating characteristics (ROC) of the single-item Distress Thermometer (DT) for detecting depression in women newly diagnosed with Stage I–III breast cancer.
Methods: We assessed 321 patients (of 345 consecutive patients) at the time of their pre-surgical consultation at a Comprehensive Breast Cancer Program. Patients were administered the DT along with the Patient Health Questionnaire 9-Item Depression Module (PHQ-9) as a gold standard diagnostic assessment of depression status.
Results: Mean DT scores (11-point scale, 0–10) were significantly higher for depressed versus non-depressed patients (8.1 versus 4.4). In ROC analyses the DT showed strong discriminatory power relative to the PHQ-9-derived diagnosis of depression, with an area under the curve of 0.87. Patient age, education, marital status and stage of disease resulted in similar operating characteristics. A score of 7 represented the optimal trade-off between sensitivity (0.81) and specificity (0.85) characteristics for detecting depression.
Conclusions: The single-item DT performs satisfactorily relative to the PHQ-9 for detecting depression in newly diagnosed breast cancer patients. A cutoff score of 7 on the DT possesses the optimal sensitivity and specificity characteristics. The strength of these findings suggests that a careful psychosocial evaluation should follow a positive screen. Copyright © 2007 John Wiley & Sons, Ltd.