Frequency of anxiety and depression and screening performance of the Edmonton Symptom Assessment Scale in a psycho-oncology clinic

Objective The primary objective of this study was to determine the frequency of screening instrument-detected depression and anxiety in outpatients on initial presentation to a consultation psychiatric oncology clinic. The secondary objectives were to identify characteristics associated with depression and anxiety among these patients, and to determine the optimal cut-off score for the ESAS-Anxiety (ESAS-A) and ESAS-Depression (ESAS-D) items, using the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder Scale (GAD-7) as a gold standard in cancer patients. Methods A retrospective chart review was conducted for 1221 consecutive cancer patients seen in the Psychiatric Oncology Center as an initial consult between June 1, 2014 and January 31, 2017. Results When the cutoff was 10 for the PHQ-9 and the GAD-7, 60% of patients self-reported depression and 51% self-reported anxiety. When the cutoff was 15 (severe symptom) for the PHQ-9 and GAD-7, approximately 30% and 27% of the patients had severe depression or anxiety, respectively. Age and gender were found to be associated with anxiety. An ESAS cutoff value of >= 3 for depression and >= 5 for anxiety resulted in sensitivity of 0.84 and 0.85 when using PHQ 9 >= 10 for depression and GAD 7 >= 10 for anxiety, respectively. Conclusions Self-reported depression and anxiety are frequent symptoms among patients at a psychiatric oncology center for an initial visit. ESAS-A and ESAS-D have good sensitivity for anxiety and depression screening of cancer patients.