Objective: Psychological distress is highly prevalent but often undiagnosed in brain tumor patients. We evaluated the psychometric properties of the Patient Health Questionnaire-2 (PHQ-2) for screening of distressed neurosurgical brain tumor patients.
Methods: A total of 226 (69% women; mean age 55.6 ± 14.7 years) consecutive patients on admission for elective brain tumor surgery were evaluated for psychological distress using the PHQ-2, the Hospital Anxiety and Depression Scale (HADS; n = 206), and the Beck Depression Inventory-II (BDI-II; n = 196). At discharge, the patients were reevaluated using the PHQ-2 and HADS.
Results: On admission, 43% and 18% of patients had moderate-severe psychological distress according to the HADS (HADS depression or anxiety score ≥ 11) and BDI-II (score ≥ 20), respectively. At discharge, there was a significant decrease in psychological distress among patients according to the PHQ-2 (p = 0.04) and HADS (p < 0.001) screening results. The PHQ-2 had marginal internal consistency (Cronbach's coefficient alpha = 0.68) and suboptimal test-retest reliability (intraclass correlation coefficient = 0.51). The PHQ-2 had acceptable psychometric properties for identifying patients with moderate-severe psychological distress according to the HADS (sensitivity = 74%, specificity = 68%, and positive predictive value (PPV) = 40%) and BDI-II (sensitivity = 71%, specificity = 65%, and PPV = 30%). Psychometric properties of the PHQ-2 were inferior for mild-severe psychological distress. Greater number of PHQ-2 depressive symptoms was associated with greater scores on the HADS and BDI-II (all ps < 0.001).
Conclusions: Psychological distress is prevalent in brain tumor patients and can be successfully identified using the PHQ-2. The PHQ-2 has moderate internal consistency. The PHQ-2 should be considered for routine use in brain tumor patients for psychological distress screening purposes.
Keywords: brain tumor; cancer; oncology; psychological distress; screening.
Copyright © 2012 John Wiley & Sons, Ltd.