title: Screening for psychological distress in two French cancer centers: feasibility and performance of the adapted distress thermometer.
abstract: OBJECTIVE
  Little is known about the prevalence of psychiatric disorders in French cancer patients. This study aimed to assess the feasibility of a screening procedure using the Psychological Distress Scale (PDS). The PDS is a French adaptation of the National Comprehensive Cancer Network Distress Thermometer. The screening performance of the PDS was assessed by comparison with the established clinical case threshold on the Hospital Anxiety and Depression Scale (HADS).
  
  
  METHODS
  Among 598 consecutive cancer outpatients recruited in two cancer centers in Paris, 561 (94%) agreed to complete the PDS, the HADS, the European Organisation for Research and Treatment of Cancer core quality of life questionnaire (EORTC QLQ-C30), and study-specific psychosocial questions.
  
  
  RESULTS
  A receiver operating characteristic (ROC) analysis was performed, using a HADS cutoff score of 15 or greater to identify patients with psychological distress. This yielded a PDS cutoff score of 3, giving 76% sensitivity and 82% specificity. With this cutoff score, the prevalence of psychological distress was 38%. PDS scores were significantly related to scores from the HAD total scale (r=.64), HAD anxiety (r=.61) and HAD depression (r=.39) subscales, and EORTC QLQ-C30 emotional functioning (r=.56) and global health state (r=.44). In multivariate analyses, factors associated with psychological distress were female gender, taking analgesics, receiving professional psychological help, perceived psychosocial difficulties and lack of social support.
  
  
  CONCLUSIONS
  Using the PDS appeared feasible, acceptable and effective for psychological distress screening in French ambulatory cancer care settings.
authors.affiliation: Unité de Psycho-Oncologic, Départment Interdiscioplinaire de Soins de Support pour le Patient en Oncologie, Paris, France. sylvie.dolbeault@curie.net
authors.forename: Sylvie
authors.initials: S
authors.lastname: Dolbeault
authors.forename: Anne
authors.initials: A
authors.lastname: Bredart
authors.forename: Véronique
authors.initials: V
authors.lastname: Mignot
authors.forename: Patrick
authors.initials: P
authors.lastname: Hardy
authors.forename: Annie
authors.initials: A
authors.lastname: Gauvain-Piquard
authors.forename: Laurence
authors.initials: L
authors.lastname: Mandereau
authors.forename: Bernard
authors.initials: B
authors.lastname: Asselain
authors.forename: Jacques
authors.initials: J
authors.lastname: Medioni
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D003863:Depression / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012737:Sex Factors; D018434:Sickness Impact Profile; D012944:Social Support; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology