title: The HADS and the DT for screening psychosocial distress of cancer patients in Taiwan.
abstract: OBJECTIVE
  This study assesses the sensitivity and specificity of Mandarin versions of two psychosocial screening tools for adjustment, anxiety and depressive disorders: the Hospital Anxiety and Depression Scale (HADS), and the Distress Thermometer (DT).
  
  
  METHODS
  The two scales were used to screen 103 consecutive cancer patients seen for psychiatric evaluation at KF-SYSCC between May and November 2004 prior to their psychiatric interviews. Each scale was tested against clinical psychiatric diagnoses based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition for their sensitivity and specificity.
  
  
  RESULTS
  For the Mandarin version of the DT, receiver operating characteristic (ROC) analyses identified a DT score of 4 as the optimal cut-off, with sensitivity and specificity of 98 and 73%, respectively. For the Mandarin version of the HADS, ROC identified a score of 9 and 8 as the optimal cutoffs for the respective anxiety and depression subscales (HADS-a and HADS-d), with sensitivities and specificities of 84 and 73, 72 and 86%, respectively. For the full scale of the HADS (HADS-t), 15 was identified as the optimal cutoff, which yielded sensitivity and specificity of 84 and 68%, respectively. Using the frequency table, the concordance rate of the two scales was found to be 72-80% based on the above optimal cut-offs.
  
  
  CONCLUSIONS
  The Mandarin versions of the HADS and the DT are efficacious for screening anxiety and depression for our population. Compared with the HADS-t, the DT appears to have not only higher sensitivity, but also higher specificity.
authors.affiliation: Department of Psychiatry, Koo Foundation Sun Yat-Sen Cancer Center (KF-SYSCC), Taipei, Taiwan. ginglongwang@kfsyscc.org
authors.forename: Ging-Long
authors.initials: GL
authors.lastname: Wang
authors.forename: Sheng-Hui
authors.initials: SH
authors.lastname: Hsu
authors.forename: An-Chen
authors.initials: AC
authors.lastname: Feng
authors.forename: Chiu-Yuan
authors.initials: CY
authors.lastname: Chiu
authors.forename: Ju-Fang
authors.initials: JF
authors.lastname: Shen
authors.forename: Yu-Ju
authors.initials: YJ
authors.lastname: Lin
authors.forename: Chun-Chiu
authors.initials: CC
authors.lastname: Cheng
mesh_terms: D000275:Adjustment Disorders / Q000175:diagnosis* / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology; D003431:Cross-Cultural Comparison; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010147:Pain Measurement / Q000706:statistics & numerical data*; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D013624:Taiwan; D014175:Translating; D055815:Young Adult