Screening young adult cancer survivors for distress with the Distress Thermometer: Comparisons with a structured clinical diagnostic interview.
BACKGROUND
The validity of the Distress Thermometer (DT) as a screen for psychological distress in young adult cancer survivors was assessed by comparing it with the results of a psychiatric diagnostic interview, the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (SCID), to evaluate the accuracy of the DT and identify optimal cutoff scores for this population.


METHODS
A total of 247 survivors aged 18 to 40 years completed the DT and SCID. Based on the SCID, participants were classified as having: 1) ≥ 1 SCID diagnoses; 2) significant symptoms, but no SCID diagnosis; or 3) no significant SCID symptoms. Receiver operating characteristic analyses determined the sensitivity and specificity of all possible DT cutoff scores for detecting survivors with a SCID diagnosis, and subsequently for survivors with significant SCID symptoms or a SCID diagnosis.


RESULTS
The recommended DT cutoff score of ≥5 failed to identify 31.81% of survivors with a SCID diagnosis (sensitivity of 68.18% and specificity of 78.33%), and 32.81% of survivors with either significant SCID symptoms or a SCID diagnosis. No alternative DT cutoff score met the criteria for acceptable sensitivity (≥85%) and specificity (≥75%).


CONCLUSIONS
The DT does not reliably identify young adult cancer survivors with psychiatric problems identified by a "gold standard" structured psychiatric interview. Therefore, the DT should not be used as a stand-alone psychological screen in this population. Cancer 2016;122:296-303. © 2015 American Cancer Society.
['Recklitis|Christopher J|CJ|', 'Blackmon|Jaime E|JE|', 'Chang|Grace|G|']
D000293:Adolescent D000328:Adult D017677:Age Distribution D001007:Anxiety D003863:Depression D039721:Diagnostic and Statistical Manual of Mental Disorders D005260:Female D006801:Humans D015994:Incidence D007407:Interviews as Topic D008297:Male D008403:Mass Screening D009369:Neoplasms D012372:ROC Curve D015203:Reproducibility of Results D018570:Risk Assessment D012680:Sensitivity and Specificity D017678:Sex Distribution D013315:Stress, Psychological D017741:Survivors D013821:Thermometers D055815:Young Adult
cancer survivors Distress Thermometer validation Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (SCID) anxiety depression