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The Diagnosis of Major Depression in Patients With Cancer: A Comparative Approach

Received February 2, 2005; revised September 2, 2005; accepted September 29, 2005. From the Dept. of Psychiatry and Behavioral Sciences, Emory Univ. School of Medicine; Dept. of Biostatistics, Rollins School of Public Health, Emory Univ., Atlanta; and the Dept. of Psychology, Univ. of Virginia School of Medicine, Charlottesville, VA. Address correspondence and reprint requests to Dr. Nemeroff, Dept. of Psychiatry and Behavioral Sciences, Emory Univ. School of Medicine, Woodruff Research Memorial Building, 101 Woodruff Circle, Suite 4000, Atlanta, GA 30322. e-mail: cnemero{at}emory.edu

Depressive symptoms not only impair quality of life in cancer patients but constitute an independent risk factor for increased mortality. In order to accurately and efficiently identify depression in cancer patients, the authors developed a biostatistical strategy to identify items of the 21-item, observer-rated Hamilton Rating Scale for Depression (Ham-D) that would optimize the diagnosis of depression among cancer patients. Exhibiting a relatively high sensitivity and specificity, our most optimal diagnostic tool contained six Ham-D items (late insomnia, agitation, psychic anxiety, diurnal mood variation, depressed mood, and genital symptoms). This study may serve as a prototype to generate valid instruments accurate for the diagnosis of major depression in other populations of cancer patients.

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