title: How do we interpret the answer "Neither" when physicians ask patients with cancer "Are you depressed or not?".
abstract: OBJECTIVE
  The aim of this study was to clarify how physicians should interpret the answer "neither" to the single-question interview, "Are you depressed or not?"
  
  
  METHODS
  Two hundred fifty-one patients with cancer were studied. The patients were directly interviewed, choosing one answer among these three: "Yes, I am depressed"; "No, I am not depressed"; or "Neither." After this, the patients completed the Hospital Anxiety and Depression Scale (HADS). The threshold of 11 or greater on HADS was used for adjustment disorder and major depressive disorder.
  
  
  RESULTS
  All patients could reply to the single question, but 10 patients did not complete HADS. Among 83, 81 and 77 patients who answered "yes," "neither," and "no," respectively, 75 (90%), 43 (65%), and 9 (12%) patients scored 11 or more on HADS. The mean score of HADS was 12.2 in patients who answered "neither," significantly higher than that of the "no" group (p < 0.0001) and significantly lower than that of the "yes" group (p < 0.0001).
  
  
  CONCLUSIONS
  Patients who answered "neither" frequently scored in a high enough range to warrant further investigation for adjustment or depressive disorder.
authors.affiliation: Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan. t_ohno@nirs.go.jp
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ohno
authors.forename: Wataru
authors.initials: W
authors.lastname: Noguchi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Shingo
authors.initials: S
authors.lastname: Kato
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Tsujii
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Suzuki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D012923:Social Class; D013315:Stress, Psychological