title: Frequency of depression among oncology outpatients and association with other symptoms.
abstract: OBJECTIVE
  Depression occurs among an estimated 15% of cancer patients (range, 1-77.5%). Our main objective was to identify the frequency of reported depression by using the Brief Edinburgh Depression Scale (BEDS) among cancer outpatients. Our secondary objective was to identify associated symptoms of cancer using the Edmonton Symptom Assessment System (ESAS) and to evaluate the screening performance of depression between ESAS and BEDS.
  
  
  METHODS
  In this multicenter prospective study conducted, we used the ESAS to collect information on nine symptoms: pain, fatigue, nausea, depression, anxiety, drowsiness, shortness of breath, lack of appetite, and feeling of well-being (each rated from 0 to 10). The BEDS was used to assess for "probable depression" (score >6). Data were analyzed using a parametric and nonparametric test.
  
  
  RESULTS
  A total of 146 patients completed the study. The prevalence of probable depression was 43/146 (29%). Probable depression was associated with increased fatigue (p = 0.008), depression (p < 0.0001), anxiety (p < 0.0001), shortness of breath (p = 0.01), and decreased feeling of well-being (p < 0.001). Among patients with probable depression, 42 (98%) patients were not using antidepressants. Regarding the sensitivity and the specificity, we determined that the optimal cutoff for using the ESAS as a depression screening tool was ≥ 2.
  
  
  CONCLUSIONS
  We found significant associations between probable depression as determined with the BEDS and five symptoms as detected with the ESAS. The vast majority of patients with probable depression were not receiving pharmacological treatment. Depression should be suspected in patients with higher symptom distress as for any one of these 5 ESAS items.
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. wadihrhondali@gmail.com
authors.forename: Wadih
authors.initials: W
authors.lastname: Rhondali
authors.forename: Elise
authors.initials: E
authors.lastname: Perceau
authors.forename: Julien
authors.initials: J
authors.lastname: Berthiller
authors.forename: Pierre
authors.initials: P
authors.lastname: Saltel
authors.forename: Veronique
authors.initials: V
authors.lastname: Trillet-Lenoir
authors.forename: Olivier
authors.initials: O
authors.lastname: Tredan
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Coulon
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
authors.forename: Marilene
authors.initials: M
authors.lastname: Filbet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D004417:Dyspnea / Q000453:epidemiology / Q000209:etiology; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000523:psychology*; D010045:Outpatients; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity
chemical_list: D000928:Antidepressive Agents