A three-tier process for screening depression and anxiety among children and adolescents with cancer.

Publisher: Wiley Country of Publication: England NLM ID: 9214524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1099-1611 (Electronic) Linking ISSN: 10579249 NLM ISO Abbreviation: Psychooncology Subsets: MEDLINE

Original Publication: Chichester, W. Sussex, England : Wiley, c1992-

Interview, Psychological*; Anxiety/*diagnosis ; Depression/*diagnosis ; Hematologic Neoplasms/*psychology ; Mass Screening/*methods ; Psychiatric Status Rating Scales/*statistics & numerical data; Adolescent ; Adult ; Anxiety/epidemiology ; Anxiety/psychology ; Child ; Depression/epidemiology ; Depression/psychology ; Early Detection of Cancer ; Female ; Hematologic Neoplasms/pathology ; Humans ; Male ; Psychiatric Status Rating Scales/standards ; ROC Curve ; Reproducibility of Results ; Sickness Impact Profile ; Surveys and Questionnaires ; Young Adult

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.
(© 2020 John Wiley & Sons Ltd.)

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Keywords: PROMIS; anxiety; cancer; depression; oncology; receiver-operating characteristics; screening

Date Created: 20200722 Date Completed: 20210614 Latest Revision: 20210614

20240829

10.1002/pon.5494

32691478