Hospital anxiety and depression scale cutoff scores for cancer patients in acute care
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The aim of this study was to determine optimal cutoff scores for the Hospital Anxiety and Depression Scale (HADS) when used in evaluating cancer patients in acute care. A total of 689 cancer patients were assessed during their first days of in-patient treatment, using the structured clinical interview for DSM and the HADS. Statistical analysis was performed using ROC curves. A total of 222 patients (32%) had a mental disorder. The area under the curve was the best in the total scale of the HADS, namely 0.73. With a score of > or =13, it is possible to detect 76% of the cases with a specificity of .60, whereas 95% of the cases can be detected with a score of > or =6 (specificity 0.21). With scores of > or =16 and > or =22, recommended by the test authors for primary care, only 59 and 30% of the comorbid cancer patients are indicated. Lower HADS cutoff scores when preferable when evaluating cancer patients than are recommended for use in primary care. When using HADS in clinical practice and epidemiological studies, it is important to decide whether, for the task at hand, high detection rates of affected patients or low misclassification rates are more important.
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There is debate whether the HADS is best assessed via the total 14-item score or two 7-item subscale scores.
“There is some debate with respect to whether the HADS is best assessed via the total 14-item score [223–225] or two 7-item subscale (anxiety and depression) scores [219, 222, 225, 226].”
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Anxiety, depression, and quality of life in German ambulatory breast cancer patients
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Integrating Prehabilitation in the Preoperative Clinic: A Paradigm Shift in Perioperative Care
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Metacognitive Therapy for Emotional Distress in Adult Cancer Survivors: A Case Series
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Self-citationValue of the Hospital Anxiety and Depression Scale in the follow up of head and neck cancer patients
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Self-citationA three‐tier process for screening depression and anxiety among children and adolescents with cancer
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- Authors
- Singer, S., Kuhnt, S., Götze, H., Hauss, J., Hinz, A., Liebmann, A., Krauß, O., Lehmann, A., & Schwarz, R.
- Affiliations
- University of London (GB)
- Leipzig University (DE)
- Helios Park-Klinikum Leipzig (DE)
- Corresponding author
- Singer, S
- Venue
- British Journal of Cancer
- Published
- 2009-02-24
- Volume
- 100
- Issue
- 6
- Pages
- 908-912
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC2661775
- OpenAlex
- W2017154400
- Cited by
- 303
- References
- 25
- Citations by year
- 2026: 16 · 2025: 23 · 2024: 20 · 2023: 20 · 2022: 27 · 2021: 22 · 2020: 24 · 2019: 15 · 2018: 23 · 2017: 20 · 2016: 13 · 2015: 17 · 2014: 15 · 2013: 16 · 2012: 8
- FWCI
- 5.33
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- www.springer.com/tdm (unspecified)
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- Hospital Anxiety and Depression Scale, cut-off values, cancer patients, acute care, anxiety, depression, mental illness, diagnostic accuracy, receiver operating characteristic
- MeSH terms
- Adult, Aged, Aged, 80 and over, Anxiety, Cross-Sectional Studies, Depression, Female, Humans, Inpatients, Male, Middle Aged, Neoplasms, Psychiatric Status Rating Scales
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