title: Agreement between HADS classifications and single-item screening questions for anxiety and depression: a cross-sectional survey of cancer patients.
abstract: BACKGROUND
  We assessed agreement between reported anxiety and depression levels of cancer patients using (i) single self-report items and (ii) the Hospital Anxiety and Depression Scale (HADS). We also explored whether anxiety and depression assessment by (i) single self-report items or (ii) the HADS was most strongly associated with a preference to be offered professional assistance. The proportion of patients indicating that they would accept (or were currently using) professional support if they were experiencing anxiety or depression was also examined.
  
  
  METHODS
  A consecutive sample of cancer patients undergoing radiotherapy at four metropolitan public hospitals in Australia completed a touch screen computer survey. A consecutive subsample of patients attending three of these treatment centres answered additional questions about psychological support preferences.
  
  
  RESULTS
  Of 304 respondents, 54% [95% confidence interval (CI) 48% to 60%] perceived that they were currently experiencing mild to severe anxiety and depression. 22% (95% CI 18% to 27%) indicated a preference to be offered professional help. There was moderate agreement between the HADS and single-item responses for categorisation of anxiety and depression. Patient-perceived mild to severe anxiety and depression levels appeared to be the best measure for identifying those with a preference to be offered professional assistance. Of a subsample of 193 respondents, 89% (95% CI 84% to 93%) indicated that if they were experiencing anxiety or depression, they would accept (or were currently using) professional support.
  
  
  CONCLUSIONS
  Single-item screening in a cancer care setting may not adequately capture clinical anxiety and depression. However, single-items assessing patients' perceived levels of anxiety and depression are useful indicators of whether patients want to be offered, and are likely to accept, psychosocial care.
authors.affiliation: School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle; Hunter Medical Research Institute, Newcastle, Australia. Electronic address: lisa.mackenzie@uon.edu.au.
authors.forename: L J
authors.initials: LJ
authors.lastname: Mackenzie
authors.affiliation: School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle; Hunter Medical Research Institute, Newcastle, Australia.
authors.forename: M L
authors.initials: ML
authors.lastname: Carey
authors.affiliation: School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle; Hunter Medical Research Institute, Newcastle, Australia.
authors.forename: R W
authors.initials: RW
authors.lastname: Sanson-Fisher
authors.affiliation: School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle; Hunter Medical Research Institute, Newcastle, Australia.
authors.forename: C A
authors.initials: CA
authors.lastname: D'Este
authors.affiliation: School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle; Hunter Medical Research Institute, Newcastle, Australia.
authors.forename: C L
authors.initials: CL
authors.lastname: Paul
authors.affiliation: School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle.
authors.forename: S L
authors.initials: SL
authors.lastname: Yoong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000473:pathology*; D001315:Australia; D003430:Cross-Sectional Studies; D003625:Data Collection; D003863:Depression / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000473:pathology* / Q000523:psychology; D010361:Patients / Q000523:psychology*; D011594:Psychometrics; D011795:Surveys and Questionnaires
keywords: HADS; anxiety; depression; oncology; questionnaire; single-item question