Depression in lung cancer patients: is the HADS an effective screening tool?

The present study aimed at comparing the efficacy in recognizing depression, in 53 patients newly diagnosed with lung cancer, of the Hospital Anxiety and Depression Scale (HADS), a self-report screening questionnaire, and the Montgomery-Asberg Depression Rating Scale (MADRS), a semi-structured clinician-rated interview. Specifically, we aimed at addressing the question of which is the best HADS cutoff for the detection of patients to be further investigated through a clinical semi-structured interview (the MADRS). The MADRS identified 92% of the patients as depressed; the HADS, 70% and 87%, using a cutoff of 11 and 8, respectively. The results suggest substantial agreement between the HADS and the MADRS when a cutoff of 8 is used (McNemar: p = 0.51; Cohen K = 0.69), while a HADS cutoff of 11 resulted in a significantly lower concordance with the MADRS (McNemar: p = 0.002; Cohen K = 0.49).