The distress thermometer as a screening measure of anxiety and depression in recently diagnosed cancer patients

Abstract

Objective: The Distress Thermometer (DT) is one of the most used and studied screening tests of psychological distress in cancer patients. However, it includes many false positives. Furthermore, it has not been adequately studied with Spanish populations or with recently diagnosed patients. This research examines the diagnostic performance of the DT with a sample of Spanish recently diagnosed cancer patients.
Method: The diagnostic performance of DT was assessed in a sample of 135 recently diagnosed cancer patients using the Hospital Anxiety and Depression Scale (HADS) and a semi-structured diagnostic interview as gold standard.
Results: The diagnostic performance of DT was acceptable (AUC=0.79) to detect psychological distress using the HADS as gold standard. The optimal cut-off score was 4 (Sensitivity=0.89; Specificity=0.56). The diagnostic performance of DT using the HADS plus the diagnostic interview as gold standard was good (AUC=0.86).The optimal cut-off score was 6 (sensitivity=0.82; Specificity=0.76).
Discussion: The DT is an appropriate screening test to detect anxiety and depressive disorders in recently diagnosed cancer patients. Increasing the cut-off score up to 6 points boosts its specificity, proving to be more useful for the detection of clinically significant distress.