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Depression assessment by oncologists and palliative care physicians

Published online by Cambridge University Press:  15 May 2012

Wadih Rhondali ,
Elise Perceau ,
Pierre Saltel ,
Veronique Trillet-Lenoir ,
Jean-Yves Blay ,
Cecile Fournel-Federico ,
Jean-Pierre Coulon ,
Olivier Tredan ,
Jean-Louis Terra  and
Yves Matillon
...Show all authors
Wadih Rhondali*
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Lyon, France Laboratoire de l'EA 4129, Santé-Individu-Société, Université Lyon 1, Lyon, France
Elise Perceau
Affiliation:
Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Lyon, France
Pierre Saltel
Affiliation:
Centre Léon Bérard, Lyon, France
Veronique Trillet-Lenoir
Affiliation:
Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Lyon, France
Jean-Yves Blay
Affiliation:
Centre Léon Bérard, Lyon, France
Cecile Fournel-Federico
Affiliation:
Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Lyon, France
Jean-Pierre Coulon
Affiliation:
Clinique Francois Chenieux, Limoges, France
Olivier Tredan
Affiliation:
Centre Léon Bérard, Lyon, France
Jean-Louis Terra
Affiliation:
Laboratoire de l'EA 4129, Santé-Individu-Société, Université Lyon 1, Lyon, France
Yves Matillon
Affiliation:
Laboratoire de l'EA 4129, Santé-Individu-Société, Université Lyon 1, Lyon, France
Eduardo Bruera
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Marilene Filbet
Affiliation:
Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Lyon, France
*
Address correspondence and reprint requests to: Wadih Rhondali, Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030. E-mail: wrhondali@mdanderson.org
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Abstract

Objective:

Depression is a frequent problem in cancer patients, which is known to reduce quality of life; however, many cancer patients with depression are not treated because of the difficulties in assessing depression in this population. Our aim was to evaluate and improve the depression assessment strategies of palliative care (PC) physicians and oncologists.

Method:

We invited all medical oncologists and PC physicians from three cancer centers to participate in this multicenter prospective study. They were asked to classify 22 symptoms (related and specific to depression in cancer patients, related but not specific, and unrelated) as “very important,” “important,” “less important,” or “not important” for the diagnosis of depression in cancer patients, at three different time points (at baseline, after a video education program, and after 4 weeks). They were also asked to complete a questionnaire exploring physicians' perceptions of depression and of their role in its systematic screening.

Results:

All 34 eligible physicians participated. Baseline performance was good, with >70% of participants correctly classifying at least seven of nine related and specific symptoms. We found no significant improvement in scores in the immediate and 4-week follow-up tests. Additionally, 24 (83%) and 23 (79%) participants expressed support for systematic depression screening and a role for oncologists in screening, respectively.

Significance of results:

Oncologists had good baseline knowledge about depression's main symptoms in cancer patients and a positive attitude toward being involved in screening. Underdiagnosis of depression is probably related to problems associated with the oncology working environment rather than the physicians' knowledge.

Keywords

DepressionDepression assessmentDepression screeningCancerOutpatients
Type
Original Articles
Information
Palliative & Supportive Care , Volume 10 , Issue 4 , December 2012 , pp. 255 - 263
Copyright
Copyright © Cambridge University Press 2012

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References

REFERENCES

Akechi, T., Okamura, H., Kugaya, A., et al. (2000). Suicidal ideation in cancer patients with major depression. Japanese Journal of Clinical Oncology, 30, 221–224.Google Scholar
Bailey, R.K., Geyen, D.J., Scott-Gurnell, K., et al. (2005). Understanding and treating depression among cancer patients. International Journal of Gynecological Cancer, 15, 203–208.Google Scholar
Barth, J. & Lannen, P. (2011). Efficacy of communication skills training courses in oncology: A systematic review and meta-analysis. Annals of Oncology, 22, 1030–1040.Google Scholar
Breitbart, W. (1995). Identifying patients at risk for, and treatment of major psychiatric complications of cancer. Supportive Care in Cancer, 3, 45–60.Google Scholar
Breitbart, W., Rosenfeld, B., Pessin, H., et al. (2000). Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. Journal of the American Medical Association, 284, 2907–2911.Google Scholar
Chochinov, H.M., Wilson, K.G., Enns, M., et al. (1994). Prevalence of depression in the terminally ill: Effects of diagnostic criteria and symptom threshold judgments. American Journal of Psychiatry, 151, 537–540.Google Scholar
Clayton, P. (1974). Mourning and depression: Their similarities and differences. Canadian Journal of Psychiatry, 1, 309–312.Google Scholar
Delgado-Guay, M., Parsons, H.A., Li, Z., et al. (2009). Symptom distress in advanced cancer patients with anxiety and depression in the palliative care setting. Supportive Care in Cancer, 17, 573–579.Google Scholar
Emanuel, E.J., Fairclough, D.L. & Emanuel, L.L. (2000). Attitudes and desires related to euthanasia and physician-assisted suicide among terminally ill patients and their caregivers. Journal of the American Medical Association, 284, 2460–2468.Google Scholar
Endicott, J. (1984). Measurement of depression in patients with cancer. Cancer, 53, 2243–2249.Google Scholar
Froissart, G.D., Chauchat, J.H. & Terra, J.L. (1985). Etudes de la démarche diagnostique: proposition méthodologique pour saisir et tester les différences d'attitude (Author: English translation here). Union Médicale du Canada, 114, 884–892.Google Scholar
Holland, J.C. & Alici, Y. (2010). Management of distress in cancer patients. Journal of Supportive Oncology, 8, 4–12.Google Scholar
Holland, J.C. & Bultz, B.D. (2007). The NCCN guideline for distress management: A case for making distress the sixth vital sign. Journal of the National Comprhensive Cancer Network, 5, 3–7.Google Scholar
Hotopf, M., Chidgey, J., Addington-Hall, J., et al. (2002). Depression in advanced disease: A systematic review. Part 1. Prevalence and case finding. Palliative Medicine, 16, 81–97.Google ScholarPubMed
Hughes, P. & Kerr, I. (2000). Transference and countertransference in communication between doctor and patient. Advances in Psychiatric Treatment, 6, 57–64.Google Scholar
Jacobsen, P.B., Shibata, D., Siegel, E.M., et al. (2011). Evaluating the quality of psychosocial care in outpatient medical oncology settings using performance indicators. Psychooncology, 20, 1221–1227.Google Scholar
Landis, J.R. & Koch, G.G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.Google Scholar
Lawrie, I., Lloyd-Williams, M. & Taylor, F. (2004). How do palliative medicine physicians assess and manage depression. Palliative Medicine, 18, 234–238.Google Scholar
Lenzi, R., Baile, W.F., Costantini, A., et al. (2011). Communication training in oncology: results of intensive communication workshops for Italian oncologists. European Journal of Cancer Care, 20, 196–203.Google Scholar
Little, L., Dionne, B. & Eaton, J. (2005). Nursing assessment of depression among palliative care cancer patients. Journal of Hospice and Palliative Nursing, 7, 98–105.Google Scholar
Lloyd-Williams, M., Dennis, M. & Taylor, F. (2004). A prospective study to determine the association between physical symptoms and depression in patients with advanced cancer. Palliative Medicine, 18, 558–563.Google Scholar
Lloyd-Williams, M., Shiels, C., Taylor, F., et al. (2009). Depression: An independent predictor of early death in patients with advanced cancer. Journal of Affective Disorders, 113, 127–132.Google Scholar
Lynch, M.E. (1995). The assessment and prevalence of affective disorders in advanced cancer. Journal of Palliative Care, 11, 10–18.Google Scholar
Mielke, P.W.J., Berry, K.J. & Johnston, J.E. (2009). Unweighted and weighted kappa as measures of agreement for multiple judges. International Journal of Management, 26, 213–223.Google Scholar
Mitchell, A.J., Chan, M., Bhatti, H., et al. (2011a). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. Lancet Oncology, 12, 160–174.Google Scholar
Mitchell, A.J., Kaar, S., Coggan, C., et al. (2008). Acceptability of common screening methods used to detect distress and related mood disorders-preferences of cancer specialists and non-specialists. Psychooncology, 17, 226–236.Google Scholar
Mitchell, A.J., Rao, S. & Vaze, A. (2011b). International comparison of clinicians' ability to identify depression in primary care: Meta-analysis and meta-regression of predictors. British Journal of General Practice, 61, 72–80.Google Scholar
Mitchell, A.J., Vaze, A. & Rao, S. (2009). Clinical diagnosis of depression in primary care: A meta-analysis. Lancet, 374, 609–619.CrossRefGoogle ScholarPubMed
Newell, S.A., Sanson-Fisher, R.W. & Savolainen, N.J. (2002). Systematic review of psychological therapies for cancer patients: Overview and recommendations for future research. Journal of the National Cancer Institute, 94, 558–584.CrossRefGoogle ScholarPubMed
Pascoe, S., Edelman, S. & Kidman, A. (2000). Prevalence of psychological distress and use of support services by cancer patients at Sydney hospitals. Australian and New Zealand Journal of Psychiatry, 34, 785–791.Google Scholar
Passik, S.D., Dugan, W., McDonald, M.V., et al. (1998). Oncologists' recognition of depression in their patients with cancer. Journal of Clinical Oncology, 16, 1594–1600.Google Scholar
Power, D., Kelly, S., Gilsenan, J., et al. (1993). Suitable screening tests for cognitive impairment and depression in the terminally ill: A prospective prevalence study. Palliative Medicine, 7, 213–218.Google Scholar
Rayner, L., Loge, J.H., Wasteson, E., et al. (2009). The detection of depression in palliative care. Current Opinion in Supportive and Palliative Care, 3, 55–60.CrossRefGoogle ScholarPubMed
Rayner, L., Price, A., Evans, A., et al. (2011a). Antidepressants for the treatment of depression in palliative care: Systematic review and meta-analysis. Palliative Medicine, 25, 36–51.CrossRefGoogle ScholarPubMed
Rayner, L., Price, A., Hotopf, M., et al. (2011b). The development of evidence-based European guidelines on the management of depression in palliative cancer care. European Journal of Cancer, 47, 702–712.Google Scholar
Rodin, G., Lloyd, N., Katz, M., et al. (2007). The treatment of depression in cancer patients: A systematic review. Supportive Care in Cancer, 15, 123–136.Google Scholar
Satin, J.R., Linden, W. & Phillips, M.J. (2009). Depression as a predictor of disease progression and mortality in cancer patients: A meta-analysis. Cancer, 115, 5349–5361.Google Scholar
Spitzer, R.L., Williams, J.B., Gibbon, M., et al. (1992). The structured clinical interview for DSM-III-R (SCID). I: History, rationale, and description. Archives of General Psychiatry, 49, 624–629.Google Scholar
Steinman, L., Frederick, J., Snowden, M. (2007). Recommendations for treating depression in community-based older adults. For the Late Life Depression Special Interest Project (SIP) panelists. American Journal of Preventive Medicine, 33, 175–181.Google Scholar
Stiefel, R., Die Trill, M., Berney, A., et al. (2001). Depression in palliative care: A pragmatic report from the Expert Working Group of the European Association for Palliative Care. Supportive Care in Cancer, 9, 477–488.Google Scholar
Strong, V., Waters, R., Hibberd, C., et al. (2008). Management of depression for people with cancer (SMaRT oncology 1): A randomised trial. Lancet, 372, 40–48.Google Scholar
Uitterhoeve, R.J., Vernooy, M., Litjens, M., et al. (2004). Psychosocial interventions for patients with advanced cancer – a systematic review of the literature. British Journal of Cancer, 91, 1050–1062.Google Scholar
van der Lee, M.L., van der Bom, J.G., Swarte, N.B., et al. (2005). Euthanasia and depression: A prospective cohort study among terminally ill cancer patients. Journal of Clinical Oncology, 23, 6607–6612.Google Scholar