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

Support Care Cancer. 2009 Aug;17(8):1129-32. doi: 10.1007/s00520-009-0604-8. Epub 2009 Mar 13.


Introduction: 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).

Results: 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).

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Depression / diagnosis*
  • Depression / etiology
  • Female
  • Humans
  • Interview, Psychological / methods
  • Lung Neoplasms / psychology*
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Surveys and Questionnaires