Screening for mental disorders in laryngeal cancer patients: a comparison of 6 methods

Abstract

Objectives: The aim of this study was to determine how accurate mental distress screening instruments are in identifying psychological sequelae in ambulatory laryngeal cancer patients who have undergone surgery.

Methods: Two-hundred and fifty subjects were tested for mental disorders according to the guidelines defined in the Diagnostic Statistical Manual of Psychological Illnesses, Version 4. Screening instruments tested were: the 'Hospital Anxiety and Depression Scale' (HADS), the subscale 'Emotional Functioning' of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), the 'Hornheider Fragebogen' (HFB), and a single-item visual analogues scale (VAS). Accuracy was assessed by calculating the sensitivity rates, specificity rates, and areas under the curve from the receiver operating characteristic curves.

Results: The relative frequency of mental disorders was 19.8%. All of the screening instruments tested were found to be highly accurate. The best levels of sensitivity and specificity were associated with the total score of the HADS.

Conclusions: These results confirm that a significant minority of laryngeal cancer patients suffer from severe mental distress, and that accurate screening for clinically significant mental disorders is possible using any of the instruments evaluated here.