Research / Training
Article
A three-tier process for screening depression and anxiety among children and adolescents with cancer
Maya Yardeni, Gadi Abebe Campino, Shira Bursztyn, Anat Shamir, Ehud Mekori – Domachevsky,
Amos Toren, Doron Gothelf Psycho-oncologie Volume 29, publication 12
Psycho-Oncology, 2020; 1-9
First published : 20 July 2020
Collections: Increasing access to psychosocial care in oncology
Objective
To establish and to evaluate the effectiveness of a three-tier screening process of depressive and anxiety disorders among children and adolescents with cancer based on questionnaires (first tier), semi-structured psychiatric interviews (second tier), and referral for psychiatric assessment and recommendations for treatment (third tier). We also aimed to determine the rates of depressive and anxiety disorders among participants.
Methods
Participants and their parents completed the Patient Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety modules. Then, they were interviewed separately using the semi-structured Affective and Anxiety Modules of the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). PROMIS cut-off values for diagnosing depressive and anxiety disorders, based on the K-SADS, were calculated by receiver-operating characteristics (ROCs).
Results
Of 91 participants 34 (37.4%) aged 7 to 21 years with cancer met the K-SADS criteria for depressive and/or anxiety disorders. The results of the ROC analyses were stronger for depressive disorders than for anxiety disorders and for more severe cases. The cut-off of 13 on the child-reported PROMIS for a major depressive episode had a sensitivity of 0.80 and a specificity of 0.82, and a cut-off of 14 on the parent-reported PROMIS for generalized anxiety disorder had a sensitivity of 0.78 and a specificity of 0.79
Conclusions
Using the K-SADS, we found that anxiety and depressive disorders are very common in youngsters with cancer. The three-tier screening process we developed for depression and anxiety in this population provides practical cut-off values for identifying depressive and anxiety disorders in children with cancer.
CONFLICT OF INTEREST
Hope for children with dysorthography