title: Validation of the distress and impact thermometer and the changes of mood during the first 6 months of treatment in gynecological cancer patients: a Kansai Clinical Oncology Group (KCOG)-G1103 prospective study.
abstract: To verify distress and impact thermometer (DIT) for screening emotional distress in gynecological cancer patients by Hospital Anxiety and Depression Scale total (HADS-T) as gold standard and to assess emotional changes by DIT and HADS-T.
  
  
  
  A prospective study was conducted in newly diagnosed gynecological cancer patients during the peri-treatment period after the cancer diagnosis followed by 6-month. We defined a HADS-T score of ≥11 as being indicative of emotional distress.
  
  
  
  117 patients were enrolled between May 1, 2011 and March 31, 2012, and 95 were eligible. The median age was 54 years (range 31-77). (1) From the baseline to 3-month, distress (DIT-D) ≥4 with Impact (DIT-I) ≥2 exhibited sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) of 0.776 [95 % confidential interval (CI) 0.688, 0.850], 0.889 (95 % CI 0.824, 0.954), 0.868 (95 % CI 0.792, 0.949), and 0.808 (95 % CI 0.731, 0.886), respectively. (2) At 6-month, DIT-D ≥2 with DIT-I ≥1 exhibited sensitivity, specificity, PPV and NPV of 0.893 (95 % CI 0.778, 1), 0.825 (95 % CI 0.707, 0.942), 0.781 (95 % CI 0.638, 0.928), and 0.917 (95 % CI 0.826, 1). (3) At 6-month, the HADS-T, DIT-D, and DIT-I scores in individual patients were significantly reduced by a mean of 4.57 (p < 0.0001), 2.34 (p < 0.0001), and 1.10 (p = 0.0031), respectively, compared with those scores of baseline (Student's paired t test), but still remained high.
  
  
  
  (1) On acute phase within 3-month setting, DIT; DIT-D ≥4 with DIT-I ≥2, is a reliable cut-off to screen emotional distress among gynecological cancer patients. (2) The patients' moods had improved, but not completely recovered at 6-month after the diagnosis.
authors.affiliation: Department of Obstetrics and Gynecology, Nara Prefecture General Medical Center, Nara, Japan. nuages@m3.kcn.ne.jp.
authors.forename: Y
authors.identifier: 0000-0002-1981-0797
authors.initials: Y
authors.lastname: Itani
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Arakawa
authors.affiliation: Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Tsubamoto
authors.affiliation: Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Nishikawa
authors.affiliation: Department of Obstetrics and Gynecology, Meiwa General Hospital, Amagasaki, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Gynecology Okayama, Ohfuku Clinic, Okayama, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Miyagi
authors.affiliation: Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hori
authors.affiliation: Department of Obstetrics and Gynecology, Nara Prefectural Seiwa Medical Center, Ikomagun-Sangocho, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Furukawa
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis*; D003863:Depression / Q000175:diagnosis*; D005260:Female; D005833:Genital Neoplasms, Female / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008495:Medical Oncology; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011594:Psychometrics / Q000379:methods*
keywords: DIT; Emotional distress; Gynecological malignancy; HADS