Agreement for depression diagnosis between DSM-IV-TR criteria, three validated scales, oncologist assessment, and psychiatric clinical interview in elderly patients with advanced ovarian cancer

Figures & data

Table 1 Patient characteristics, N=99

Variables	N (%)
Age in years, mean (SD)	78 (5)
≥80	38 (38)
≥85	11 (11)
PS, N (%)
0–1	52 (53)
2–3	47 (47)
ADL, median (Q1–Q3)	5.5 (5–6)
Number of patients with an ADL ≤4	10 (10)
(moderate impairment), N (%)
IADL, median (Q1–Q3)	22 (17–26)
Number of patients with an IADL ≤24, N (%)	68 (69)
Depression according to DSM criteria, N (%)	15 (15)
Depression according to PCI, N (%)	39 (39)
Overall survival in months, mean (SD)	15.7 (9.2)

Abbreviations: ADL, Activities of Daily Living scale; DSM, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised; IADL, Instrumental Activities of Daily Living scale; N, number; PCI, psychiatric clinical interview; PS, performance status; Q1–Q3, first through third quartiles; SD, standard deviation.

Table 2 Comparison of depression diagnosis using different strategies between depressed and nondepressed patients according to DSM diagnosis, N=99

Variables	Depressed patients	Nondepressed patients	κ coefficient	P-value*
DT ≥4	50 (60)	8 (53)	−0.060 (−0.189; 0.069)	<0.001
MT >4	36 (43)	8 (53)	0.058 (0.096; 0.212)	<0.001
GDS ≥10	17 (20)	15 (100)	0.508 (0.326; 0.690)	<0.001
HADS >14	28 (33)	8 (53)	0.127 (−0.051; 0.305)	0.01
HDRS ≥7	49 (58)	15 (100)	0.151 (0.051; 0.251)	<0.001
MADRS ≥16	8 (10)	14 (94)	0.663 (0.473; 0.853)	0.109
PCI	24 (29)	15 (100)	0.431 (0.268; 0.594)	<0.001
OA	15 (18)	2 (13)	−0.043 (−0.228; 0.223)	0.851

Note:

* McNemar’s test.

Abbreviations: κ, Cohen’s kappa coefficient; DSM, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised; DT, Distress Thermometer; GDS, Geriatric Depression Scale; HADS, Hospital Anxiety Depression Scale; HDRS, Hamilton Depression Rating Scale; MADRS, Montgomery Asberg Depression Rating Scale; MT, Mood Thermometer; N, number; OA, oncologist assessment; PCI, psychiatric clinical interview.

Table 3 Sensitivity and specificity of the different assessments to DSM

Variables	Sensitivity	Specificity	PPV	NPV
DT ≥4	0.50	0.40	0.14	0.81
MT >4	0.50	0.57	0.18	0.86
GDS ≥10	0.94	0.80	0.47	0.99
HADS ≥16	0.50	0.67	0.22	0.88
HDRS ≥7	0.94	0.42	0.23	0.97
MADRS ≥16	0.88	0.91	0.63	0.97
PCI	1.00	0.71	0.38	1.00
OA	0.13	0.82	0.12	0.84

Abbreviations: DSM, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised; DT, Distress Thermometer; GDS, Geriatric Depression Scale; HADS, Hospital Anxiety Depression Scale; HDRS, Hamilton Depression Rating Scale; MADRS, Montgomery Asberg Depression Rating Scale; MT, Mood Thermometer; NPV, Negative Predictive Value; OA, oncologist assessment; PCI, psychiatric clinical interview; PPV, Positive Predictive Value.

Table 4 Associations between depression diagnosis according to DSM and patient characteristics, N=99

Variables	No depression (DSM) N=84	Depression (DSM) N=15	P-value
Age (years), median (Q1–Q3)	78 (73–82)	78 (76–82)	0.261*
PS 2–3, N (%)	37 (44)	10 (67)	0.106‡
ADL, median (Q1–Q3)	6 (5–6)	6 (5–6)	0.737*
IADL, median (Q1–Q3)	22 (16–26)	22 (17–26)	0.357*
Survival in months, median (Q1–Q3)	15.2 (9.4–22.8)	14.9 (3.0–18.3)	0.281*

Notes:

* Mann–Whitney U-test;

‡ chi-square test.

Abbreviations: ADL, Activities of Daily Living scale; DSM, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised; IADL, Instrumental Activities of Daily Living scale; N, number; PS, performance status; Q1–Q3, first through third quartiles.

Figure S1 Kaplan–Meier estimates of overall survival according to the presence or the absence of depression using DSM criteria.

Abbreviation: DSM, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised.