Intensity and prevalence of depressive states in cancer inpatients: a large sample descriptive study.

In cancer patients, depression causes suffering during the whole disease trajectory and it also influences the personal perception of well-being as well as treatment adherence. Consequently, its better definition is needed for planning more tailored supportive programmes. This study was aimed to provide information on depressive state intensity and prevalence in an heterogeneous sample of cancer inpatients. In addition, associations were studied between depressive state and different socio-demographic and clinical factors. A total of 1,147 consecutive adult cancer inpatients completed the Center for Epidemiologic Studies Scale on Depression together with a form for collecting socio-demographic and clinical data. The mean score of depression was 16.9 (SD = 9.3). There were differences in depression intensity associated with gender (p < .001), age (p = .001) and cancer type (p < .001), but not with education level (p = .282) or marital status (p = .436). Of the entire sample 13.9% had depressive states; this percentage raised to 26.2% if a less stringent criterion was used. These data reinforce the importance of a clinical and research focus on depression in oncology. As differences according to gender, age and diagnosis exist in depression prevalence and intensity, tailored supportive intervention should be planned and verified for effectiveness and efficacy.

Cognitive functioning self-assessment scale (CFSS): preliminary psychometric data.

The cognitive functioning is included in the concept of quality of life. Many times well-being remains incomplete because of cognitive difficulties, that people are not always able to properly recognize and explain. Nonetheless, only few instruments, specifically thought for non-clinical neurologic populations, are available to measure them. The present study is an attempt at providing a self-report instrument--cognitive functioning self-assessment scale (CFSS)--to measure the individual cognitive functioning in general population. The CFSS is itemized into18 questions to which participants answer on a five-point scale. Two hundred and eighty-two patients in a General Practitioner study have filled-in the CFSS together with a clinical and socio-demographic data form. Explorative factor analysis, using principal component analysis, suggests the consideration of the CFSS as one-dimensional; internal reliability = 0.856. Non-parametric tests have shown that women report a worse cognitive functioning than men, while no differences emerged in relation to age, manual prevalence, presence of an illness or being in pharmacological treatment. Although further verifications are necessary, the CFSS seems to be a promising self-report cognitive functioning measure.

Defining hospital anxiety and depression scale (HADS) structure by confirmatory factor analysis: a contribution to validation for oncological settings.

BACKGROUND: Despite its popularity, not a definitive word has yet been said about the latent structure of the Hospital Anxiety and Depression Scale (HADS). The present work is a contribution to this issue: statistically identifying the best tool structure helps in understanding which constructs the tool actually detects. PARTICIPANTS AND METHODS: Five hundred and twelve Italian consecutive hospitalized cancer patients completed the HADS together with a form for the collection of personal and clinical data. Two confirmatory factor analyses (CFAs) were carried out to test the validity of both two- and one-factor models, whereas qualitative and quantitative (i.e. Akaike information criterion) indices were used to assess which model among them would fit better with the observed data. Finally, two multigroup CFAs were carried out to test the factorial invariance across gender and disease phase (diagnostic, therapeutic) of the best-fitting model. RESULTS: Although both considered models provide a good fit to the observed data, the two-factor model is more adequate; it is invariant across gender and disease phase. CONCLUSIONS: The present study gives evidence for using HADS to detect anxious and depressive states separately as originally suggested by its authors. Given that this work involved only Italian cancer inpatients, replications in different cultural/national contexts are recommended.