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Screening for psychological distress in two French cancer centers: Feasibility and performance of the adapted distress thermometer

Published online by Cambridge University Press:  23 May 2008

Sylvie Dolbeault*
Affiliation:
Unité de Psycho-Oncologic, Départment Interdisciplinaire de Soins de Support pour le Patient en Oncologie, Paris cedex, France Université Paris-Sud, Paris, France Université Paris V, Paris, France INSERM, Paris, France
Anne Bredart
Affiliation:
Unité de Psycho-Oncologic, Départment Interdisciplinaire de Soins de Support pour le Patient en Oncologie, Paris cedex, France Laboratoire de Psychopathologie et Neuropsychologie clinique, Université Paris V, Paris, France
Véronique Mignot
Affiliation:
Unité de Psycho-Oncologic, Départment Interdisciplinaire de Soins de Support pour le Patient en Oncologie, Paris cedex, France
Patrick Hardy
Affiliation:
Université Paris-Sud, Paris, France INSERM, Paris, France AP-HP, Le Kremlin-Bicêtre, Paris, France
Annie Gauvain-Piquard
Affiliation:
Unité de Psycho-Oncologie, Institut Gustave Roussy, Villejuif, France
Laurence Mandereau
Affiliation:
Service de Biostatistiques, Institut Curie26, Paris cedex, France
Bernard Asselain
Affiliation:
Service de Biostatistiques, Institut Curie26, Paris cedex, France
Jacques Medioni
Affiliation:
Service de Biostatistiques, Institut Curie26, Paris cedex, France
*
Address correspondence and reprint requests to: Sylvie Dolbeault, Unité de psycho-oncologie, Institut Curie, 26 rue d'Ulm, 75248 Paris cedex 05, France. E-mail: [email protected]

Abstract

Objective:

Little is known about the prevalence of psychiatric disorders in French cancer patients. This study aimed to assess the feasibility of a screening procedure using the Psychological Distress Scale (PDS). The PDS is a French adaptation of the National Comprehensive Cancer Network Distress Thermometer. The screening performance of the PDS was assessed by comparison with the established clinical case threshold on the Hospital Anxiety and Depression Scale (HADS).

Methods:

Among 598 consecutive cancer outpatients recruited in two cancer centers in Paris, 561 (94%) agreed to complete the PDS, the HADS, the European Organisation for Research and Treatment of Cancer core quality of life questionnaire (EORTC QLQ-C30), and study-specific psychosocial questions.

Results:

A receiver operating characteristic (ROC) analysis was performed, using a HADS cutoff score of 15 or greater to identify patients with psychological distress. This yielded a PDS cutoff score of 3, giving 76% sensitivity and 82% specificity. With this cutoff score, the prevalence of psychological distress was 38%. PDS scores were significantly related to scores from the HAD total scale (r = .64), HAD anxiety (r = .61) and HAD depression (r = .39) subscales, and EORTC QLQ-C30 emotional functioning (r = .56) and global health state (r = .44). In multivariate analyses, factors associated with psychological distress were female gender, taking analgesics, receiving professional psychological help, perceived psychosocial difficulties and lack of social support.

Significance of results:

Using the PDS appeared feasible, acceptable and effective for psychological distress screening in French ambulatory cancer care settings.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2008

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