scholarly journals Identification of Anxiety and Depression Symptoms in Patients With Cancer: Comparison Between Short and Long Web-Based Questionnaires (Preprint)

2018 ◽  
Author(s):  
Susanne Mattsson ◽  
Erik Martin Gustaf Olsson ◽  
Maria Carlsson ◽  
Birgitta Beda Kristina Johansson

BACKGROUND Physicians and nurses in cancer care easily fail to detect symptoms of psychological distress because of barriers such as lack of time, training on screening methods, and knowledge about how to diagnose anxiety and depression. National guidelines in several countries recommend routine screening for emotional distress in patients with cancer, but in many clinics, this is not implemented. By inventing screening methods that are time-efficient, such as digitalized and automatized screenings with short instruments, we can alleviate the burden on patients and staff. OBJECTIVE The aim of this study was to compare Web-based versions of the ultrashort electronic Visual Analogue Scale (eVAS) anxiety and eVAS depression and the short Hospital Anxiety and Depression Scale (HADS) with Web-based versions of the longer Montgomery Åsberg Depression Rating Scale-Self-report (MADRS-S) and the State Trait Anxiety Inventory- State (STAI-S) with regard to their ability to identify symptoms of anxiety and depression in patients with cancer. METHODS Data were obtained from a consecutive sample of patients with newly diagnosed (<6 months) breast, prostate, or colorectal cancer or with recurrence of colorectal cancer (N=558). The patients were recruited at 4 hospitals in Sweden between April 2013 and September 2015, as part of an intervention study administered via the internet. All questionnaires were completed on the Web at the baseline assessment in the intervention study. RESULTS The ultrashort and short Web-based-delivered eVAS anxiety, eVAS depression and HADS were found to have an excellent ability to discriminate between persons with and without clinical levels of symptoms of anxiety and depression compared with recommended cutoffs of the longer instruments MADRS-S and STAI-S (area under the curve: 0.88-0.94). Cutoffs of >6 on HADS anxiety and >7 hundredths (hs) on eVAS anxiety identified patients with anxiety symptoms with high accuracy. For HADS depression, at a cutoff of >5 and eVAS depression at a cutoff of >7 hs, the accuracy was very high likewise. CONCLUSIONS The use of the short and ultrashort tools, eVAS and HADS, may be a suitable initial method of Web-based screening in busy clinical settings. However, there are still a proportion of patients who lack access to the internet or the ability to use it. There is a need to find solutions for this group to find all the patients with psychological distress.

10.2196/11387 ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. e11387 ◽  
Author(s):  
Susanne Mattsson ◽  
Erik Martin Gustaf Olsson ◽  
Maria Carlsson ◽  
Birgitta Beda Kristina Johansson

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S188-S189
Author(s):  
C Canaletti ◽  
F Colombo ◽  
A Dessì ◽  
E Geccherle ◽  
A Tongiorgi ◽  
...  

Abstract Background Roughly 50% of patients with IBD have symptoms of psychological distress (Mikocka-Walus et al. 2019) but only 15.2% receive attention for their mental health although the effect on disease severity can be profound. It is necessary to have an easy-to-administer psychological distress screening tool. The distress thermometer (DT) is a single-item distress screening scale with 11-likert response widely used in oncological patients. The aim of study was to determine whether the single-item DT compared favourably with IBD clinical indices and time consuming measures currently used to screen for distress. Methods Two hundered and twenty IBD patients (51.43% male) who were recruited in eight Italian hospitals completed the DT and identified the presence or absence of 34 problems using standardised problem list (PL). They completed the 14-item Hospital Anxiety and Depression Scale (HADS) and the 32-item Inflammatory Bowel Disease Questionnaire (IBDQ). Disease clinical indices have been collected for each patient (Mayo score, Harvey–Bradshaw Index–HBI, years of illness, and exacerbation in the last year). Using receiver operating characteristic (ROC) analyses validated the use of the DT in Italian IBD population. Results 47.6% reported anxiety and depression symptoms (HADS ≥15) and needs emotional care. Anxiety is much more associated (43.8%) than depressive problems (26.2%). Data are confirmed by responses to DT and PL: 44.5% of patients reported moderate–severe emotional distress (TD ≥ 5), 43.1% of patients report nervousness and worry, 27.1% reported depression. We observed a strong positive correlation between IBDQ and HADS (r = 0.74, p &lt; 0.001) and DT (r = 0.58, p &lt; 0.001), while there was a slightly smaller association with Mayo score (r = 0.46, p &lt; 0.001) and HBI (r = 0.39, p &lt; 0.001). There was not a statistical significant correlation between disease indices and the emotional distress as measured by HADS or DT. ROC analyses showed that a DT cutoff score of 5 or higher had optimal sensitivity (83%) and specificity (68%) relative to the HADS score as ‘gold’ standard. DT scores yielded area under the curve estimates relative to the HADS cutoff score indicative of good overall accuracy (AUC = 0.81–95% CI: 0.77–0.85). Conclusion Our study confirms that anxiety and depression symptoms are associated with IBD. This is the first study that demonstrated that DT is an easy-to-administer screening tool of psychosocial distress in IBD population. We propose that gastroenterologists use DT to identify patients with psychological distress: an early psychological support and a multidisclinar equipe can determinate a patient’s better disease course (Mawdsley et al. 2005). Our analyses indicated that using a DT’s cutoff of 5 to indicate high levels of distress.


2015 ◽  
Vol 33 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Maria Kourti ◽  
Efstathia Christofilou ◽  
George Kallergis

<p><strong>Objective:</strong> This study investigated symptoms of anxiety and depression in relatives of patients admitted in the Intensive Care Unit and determined whether these symptoms were associated to the seriousness of the patients’ condition.</p><p><strong>Metodology:</strong> A total of 102 patients’ relatives were surveyed<br />during the study. They were given a self-report questionnaire in order to assess demographic data, anxiety and depression symptoms. The symptoms of anxiety and depression were evaluated with the Hospital Anxiety and Depression Scale (hads). Patient’s condition was evaluated with a.p.a.ch.e ii Score.</p><p><strong>Results:</strong> More than 60% of patients’ relatives presented severe symptoms of anxiety and depression. No relation was found between symptoms of anxiety and depression of the relatives of patients and patients’ condition of health. On the<br />contrary, these feelings used to exist regardless of the seriousness of patient’s condition.</p><p><strong>Conclusions:</strong> The assessment of these patients is recommended in order serious problems of anxiety<br />and depression to be prevented. </p>


2015 ◽  
Vol 32 (10) ◽  
pp. 1501-1523 ◽  
Author(s):  
Meghan W. Cody ◽  
Judiann M. Jones ◽  
Matthew J. Woodward ◽  
Catherine A. Simmons ◽  
J. Gayle Beck

Intimate partner violence (IPV) has potentially severe and long-lasting mental health consequences for survivors, including elevated symptoms and diagnoses of posttraumatic stress disorder (PTSD), depression, and generalized anxiety disorder (GAD). The current study examined the relationship between three self-report measures of psychological distress and ratings obtained from the corresponding clinician-administered measures in women seeking assessment for mental health problems following IPV ( N = 185). PTSD symptoms were assessed using the self-report Impact of Event Scale–Revised (IES-R) and the interview-based Clinician-Administered PTSD Scale (CAPS). Depression symptoms were assessed using the self-report Beck Depression Inventory–II (BDI-II) and the depressive disorders sections from the clinician-administered Anxiety Disorders Interview Schedule–IV (ADIS-IV). Anxiety symptoms were assessed using the self-report Beck Anxiety Inventory (BAI) and the clinician-administered GAD section from the ADIS-IV. Results indicated that psychological distress was prevalent in the sample, with 27% receiving a PTSD diagnosis, 40% diagnosed with a depressive disorder, and 55% meeting criteria for GAD. Although each self-report measure was significantly and positively correlated with its corresponding clinician-administered measure, rates of diagnostic concordance were mixed. The BDI-II showed a high degree of agreement with the ADIS-IV depression section, but the IES-R and the CAPS were discordant at classifying PTSD. The BAI had acceptable sensitivity but poor specificity in relation to the ADIS-IV GAD section. These findings suggest that multiple assessment modalities should be considered when rating symptoms and estimating the prevalence of diagnoses among survivors of IPV.


2009 ◽  
Vol 15 (3) ◽  
pp. 393-398 ◽  
Author(s):  
K Poder ◽  
K Ghatavi ◽  
JD Fisk ◽  
TL Campbell ◽  
S Kisely ◽  
...  

Background Little is known about social anxiety in MS. Objective We estimated the prevalence of social anxiety symptoms and their association with demographic and clinical features in a clinic-attending sample of patients with MS. Methods Patients attending the Dalhousie MS Research Unit for regularly scheduled visits completed the Social Phobia Inventory (SPIN), the Hospital Anxiety and Depression Scale (HADS), and the Health Utilities Index (HUI). Neurological disability was determined by ratings on the Expanded Disability Status Scale (EDSS). Results A total of 251 patients completed self-report scales of anxiety and depression symptoms. In all, 245 (98%) provided sufficient data for analysis. In all, 30.6% ( n = 75) had clinically significant social anxiety symptoms as defined by a SPIN threshold score of 19. Half of those with social anxiety had general anxiety (HADSA ≥ 11) and a quarter had depression (HADSD ≥ 11). Severity of social anxiety symptoms was associated with reduced health-related quality of life and not related to neurological disability. Conclusions Social anxiety symptoms are common in persons with MS, contribute to overall morbidity, but are unrelated to the overall severity of neurologic disability. Greater awareness and routine systematic inquiry of social anxiety symptoms is an important component of comprehensive care for persons with MS.


2020 ◽  
Vol 38 (1) ◽  
Author(s):  
Fatemeh KHademian ◽  
Mahsa Roozrokh Arshadi Montazer ◽  
Azam Aslani

Objective. This study aimed to assess web-based health information seeking and eHealth literacy among Iranian college students. Methods. The study was conducted in five colleges of the Shiraz University of Medical Sciences in Iran during 2018. The data were collected by a researcher-made questionnaire consisting of seven questions on a 4-point Likert-type scale, with scores ranging from 7 to 28. These questions were: ′I know how to use the Internet to answer my questions about health′, ′I think there is enough information about health-related issues on the Internet′, ′I know the vocabulary used in health issues on the Internet′, ′I can tell high-quality health resources from low-quality health resources on the Internet′, ′I know how to use the health information I find on the Internet to help me′, ′I feel confident in using information from the Internet to make health decisions′, and ′Searching for health-related information on the Internet will increase my knowledge in this field′. High eHealth literacy level is defined as above the total mean score and low eHealth literacy level is defined as lower than the total mean score. Results. In all, 386 college students participated in the study. The results showed that the mean score of eHealth literacy was 19.11 out of 28; 205 participants (54.4%) had low eHealth literacy. In addition, the students used the Internet to search for information regarding diseases symptoms (70%), physical illnesses (67.1%), existing treatments (65%), and diagnosis (63.1%). Conclusion. The results showed that participants in this study usually searched for illnesses, symptoms, and treatments after they got sick and paid little attention to other aspects related to integral health.How to cite this article: KHademian F, Roozrokh M, Aslani A. Web-based health Information Seeking and eHealth Literacy among College students. A Self-report study. Invest. Educ. Enferm. 2020. 38(1):e08.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Qiuping Huang ◽  
Xinxin Chen ◽  
Shucai Huang ◽  
Tianli Shao ◽  
Zhenjiang Liao ◽  
...  

AbstractThe coronavirus disease 2019 (COVID-19) has adversely influenced human physical and mental health, including emotional disorders and addictions. This study examined substance and Internet use behavior and their associations with anxiety and depression during the COVID-19 pandemic. An online self-report questionnaire was administered to 2196 Chinese adults between February 17 and 29, 2020. The questionnaire contained the seven-item Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire (PHQ-9), questions on demographic information, and items about substance and Internet use characteristics. Our results revealed that males consumed less alcohol (p < 0.001) and areca-nut (p = 0.012) during the pandemic than before the pandemic. Age, gender, education status, and occupation significantly differed among increased substance users, regular substance users, and nonsubstance users. Time spent on the Internet was significantly longer during the pandemic (p < 0.001) and 72% of participants reported increased dependence on the Internet. Compared to regular Internet users, increased users were more likely to be younger and female. Multiple logistic regression analysis revealed that age <33 years (OR = 2.034, p < 0.001), increased substance use (OR = 3.439, p < 0.001), and increased Internet use (OR = 1.914, p < 0.001) were significantly associated with depression. Moreover, anxiety was significantly related to female gender (OR = 2.065, p < 0.001), “unmarried” status (OR = 1.480, p = 0.017), nonstudents (OR = 1.946–3.030, p = 0.001), and increased substance use (OR = 4.291, p < 0.001). Although there was a significant decrease in social substance use during the pandemic, more attention should be paid to increased Internet use. Increased Internet use was significantly associated with both anxiety and depression, and increased substance use was related to depression. Professional support should be provided to vulnerable individuals to prevent addiction.


2019 ◽  
Vol 5 (1) ◽  
pp. 40-49 ◽  
Author(s):  
C. Penlington ◽  
V. Araújo-Soares ◽  
J. Durham

Introduction: Persistent orofacial pain (POFP) can be caused by a range of conditions affecting the mouth and face and is often associated with significant disability. Biopsychosocial factors are known to be important predictors and have not yet been fully explored in this population. Objectives: This study aimed to explore whether illness perceptions and psychological distress (anxiety and depression) could predict long-term outcome in a community-based sample of patients receiving routine care for POFP. Methods: A longitudinal cohort design study assessed 198 patients recruited from primary or secondary health care settings on 5 separate occasions over a 2-y period. Outcome was measured by the Graded Chronic Pain Scale and dichotomized into good or poor outcome categories. Independent variables included subscale scores of the psychometrically shortened Illness Perception Questionnaire and the Patient Health Questionnaire–4 (PHQ-4, assessing anxiety and depressive symptomatology). Logistic regressions were performed to test whether scores on each subscale would be associated with different outcomes for patients at 12 and 24 mo and overall. Results: Beliefs about consequences predicted outcome category (good vs. poor) above and beyond other illness perception subscales, anxiety, and depressive symptomatology (z = 3.78; P < 0.000; odds ratio [OR], 3.05; 95% confidence interval [CI], 1.71–5.43). Both depressive symptomatology, measured by the PHQ-2 (P = 0.001; OR, 4.06; 95% CI, 1.74–9.52), and psychological distress (mixed anxiety and depression; P = 0.029; OR, 2.88; 95% CI, 1.12–7.41), measured by the PHQ-4, were also predictive of poor outcome, but these effects were no longer significant once measures of illness perceptions were added. Conclusion: Beliefs about the consequences of POFP are important predictors of outcome independent of other variables and can easily and briefly be included in assessments to inform management decisions. Knowledge Transfer Statement: The results of this study are relevant because they will allow clinicians to consider the use of brief and easy-to-administer self-report measures to identify POFP patients at higher risk of poor outcome so that management can be planned accordingly.


2020 ◽  
Vol 9 (10) ◽  
pp. 3174
Author(s):  
Claudia Trudel-Fitzgerald ◽  
Shelley S. Tworoger ◽  
Xuehong Zhang ◽  
Edward L. Giovannucci ◽  
Jeffrey A. Meyerhardt ◽  
...  

Given the unalterable nature of most risk factors for colorectal cancer (CRC) survival (e.g., disease stage), identifying modifiable determinants is critical. We investigated whether anxiety and depression were related to CRC survival using data from the Nurses’ Health Study (NHS) and Health Professional Follow-up Study (HPFS). Participants who received a CRC diagnosis and provided information about anxiety (nNHS = 335; nHPFS = 232) and depression (nNHS = 893; nHPFS = 272) within 4 years of diagnosis were included. Cox regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) of overall mortality, while controlling for covariates (sociodemographics, cancer characteristics, and lifestyle factors). Pooled risk estimates were derived from fixed effects meta-analyses of the cohorts. Among 1732 CRC patients, 814 deaths occurred during the 28-year follow-up. Each 1 standard deviation increase in anxiety or depression symptoms was associated with a similar 16% higher mortality risk (anxiety: 95% CI = 1.05–1.29; depression: 95% CI = 1.07–1.26). Comparable results were observed across all sensitivity analyses (introducing a 1-year lag, restricting to CRC-related mortality, considering potential behavioral pathways) and stratified models (cancer stage, sex). Our findings suggest greater anxiety and depression symptoms can not only impede adherence to healthy habits and reduce quality of life in cancer patients but could also be a marker for accelerated CRC progression.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A121-A122
Author(s):  
S T Nguyen-Rodriguez ◽  
O M Buxton

Abstract Introduction Chronotype refers to a preference for morning hours (morningness) vs. evening hours (eveningness) when individuals tend to feel their best (e.g., higher energy levels). People may be classified at either end of this spectrum or along a continuum between these preferences. Among adolescents, eveningness is positively related to depression and anxiety, whereas morningness is negatively related to depression. However, less is known about the relationship of chronotype and psychological health in pre-teens and Latinx youth. The present study explored associations of morningness/eveningness with anxiety symptoms, depressive symptoms, and perceived stress among Latinx pre-adolescents in Southern California. Methods A purposive sample of 100 Latinx children, ages 10-12 years old, completed self-report surveys in their homes or a preferred location chosen by the parent. Measures included the Morningness/Eveningness Scale for Children (higher scores indicate morning preference), Revised Child Anxiety and Depression Scale and the Perceived Stress Scale (higher scores indicate higher anxiety, depression and stress, respectively). Associations were tested with Pearson correlations. Results The sample was 47% male with a mean±SD age of 10.9±0.8 years. Average score for morningness/eveningness was M=30.2±4.4 (range: 18-41), for anxiety symptoms was M=0.7±0.7 (range: 0-2.8), for depression symptoms was M=0.5±0.4 (range: 0-1.9) and for perceived stress was M=15.2±5.8 (range: 2-30). Greater morningness/eveningness scores, indicating more morningness, were associated with lower scores for anxiety symptoms (r=-.41, p&lt;.001), depressive symptoms (r=-.36, p&lt;.001) and perceived stress (r=-.33, p=.001). Conclusion As has been found for adolescents, higher morningness in Latinx pre-teens was related to less frequent anxiety and depression symptoms, as well as lower perceived stress. Youth experience a circadian phase delay during adolescence, shifting their preference toward eveningness, which may exacerbate stressors and negative mental health. Therefore, interventions to promote psychological well-being in pre-adolescents may help prevent worse psychological outcomes in Latinx children as they transition to adolescence. Support This work was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Numbers UL1GM118979, TL4GM118980, and RL5GM118978.


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