Abstract
Objective: To establish and to evaluate the effectiveness of a three-tier screening process of depressive and anxiety disorders among children and adolescents with cancer based on questionnaires (first tier), semistructured psychiatric interviews (second tier), and referral for psychiatric assessment and recommendations for treatment (third tier). We also aimed to determine the rates of depressive and anxiety disorders among participants. Methods: Participants and their parents completed the Patient Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety modules. Then, they were interviewed separately using the semistructured Affective and Anxiety Modules of the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). PROMIS cutoff values for diagnosing depressive and anxiety disorders, based on the K-SADS, were calculated by receiver-operating characteristics (ROCs). Results: Of 91 participants 34 (37.4%) aged 7 to 21 years with cancer met the K-SADS criteria for depressive and/or anxiety disorders. The results of the ROC analyses were stronger for depressive disorders than for anxiety disorders and for more severe cases. The cutoff of 13 on the child-reported PROMIS for a major depressive episode had a sensitivity of 0.80 and a specificity of 0.82, and a cutoff of 14 on the parent-reported PROMIS for generalized anxiety disorder had a sensitivity of 0.78 and a specificity of 0.79. Conclusions: Using the K-SADS, we found that anxiety and depressive disorders are very common in youngsters with cancer. The three-tier screening process we developed for depression and anxiety in this population provides practical cutoff values for identifying depressive and anxiety disorders in children with cancer.
| Original language | English |
|---|---|
| Pages (from-to) | 2019-2027 |
| Number of pages | 9 |
| Journal | Psycho-Oncology |
| Volume | 29 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 2020 |
| Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2020 John Wiley & Sons Ltd
Funding
We thank all patients and their families who participated and to the staff involved in data collection. This research was funded by Abraham Rothstein fund through the Israel Cancer Association, by the Gesner Foundation for Medical Research, and Foundation Dora. We thank Eyal Shemesh, M.D for his comments on the draft of the manuscript. We thank all patients and their families who participated and to the staff involved in data collection. This research was funded by Abraham Rothstein fund through the Israel Cancer Association, by the Gesner Foundation for Medical Research, and Foundation Dora. We thank Eyal Shemesh, M.D for his comments on the draft of the manuscript. Foundation Dora; Gesner Foundation for Medical Research; Abraham Rothstein fund through the Israel Cancer Association, Grant/Award Number: 20170158 Funding information
| Funders | Funder number |
|---|---|
| Abraham Rothstein fund | |
| Foundation Dora | |
| Gesner Foundation for Medical Research | |
| Glenn Foundation for Medical Research | |
| John Randolph and Dora Haynes Foundation | |
| Israel Cancer Association |
Keywords
- PROMIS
- anxiety
- cancer
- depression
- oncology
- receiver-operating characteristics
- screening
