A prospective observational cohort study to screen major depressive disorders in geriatric oncology—Comparison of different scales

Abstract

Objective: Systematic depression screening is recommended for older patients with cancer. The objective of this study was to evaluate the performance of three mood disorder screening scales frequently used in geriatric oncology to help in diagnosing major depressive disorder (MDD). Methods: A prospective multicentre study was conducted in patients 70 years of age and over with cancer, comparing three self-report questionnaires: the 15-item Geriatric Depression Scale (GDS-15), the Hospital Anxiety and Depression Scale – Depression (HADS-D) and the Distress Thermometer (DT). In the event of abnormal scores, a psychologist consultation was suggested and a reassessment of the patient's mood was planned within 3 weeks. Potential differences between initial abnormal screening score and confirmed MDD (according to the Diagnostic and Statistical Manual of Mental Disorders criteria [DSM-5]) were assessed using variance analysis for each screening scale. Results: Ninety-three patients with a median age of 81 years (70–95) were included. Sixty-six patients had at least one abnormal score on one of the screening scales. MDD was confirmed in 10 of the 36 reassessed patients. Analysis of ROC curves showed that the HADS-D significantly predicted MDD (AUC = 0.760, IC95%: 0.603–0.917; p = 0.017), but not the GDS-15 or the initial DT. Conclusion: The HADS-D could better detect MDD, to confirm in a larger sample.