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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 1/2006

01-01-2006 | Original Article

Screening for mental disorders in cancer, cardiovascular and musculoskeletal diseases

Comparison of HADS and GHQ-12

Authors: Martin Härter, MD, PhD, Sonja Woll, Alexandra Wunsch, Jürgen Bengel, Katrin Reuter, PhD

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 1/2006

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Abstract

Objective

The early detection of patients with comorbid mental illness is of high clinical importance in chronic somatic diseases. To identify cases, screening instruments are recommended. The study compared the discriminant validity of the Hospital Anxiety and Depression Scale (HADS) and the General Health Questionnaire (GHQ-12) to detect mental disorders in the most frequent chronic somatic diseases.

Methods

Five hundred sixty-nine patients with musculoskeletal, cardiovascular, and cancer diseases participated in the cross-sectional, two-stage survey. First, patients were assessed with the GHQ-12 and the HADS. Second, they were examined for DSM-IV mental disorders by clinical standardized interview (CIDI). Using CIDI diagnosis as a criterion, the validity of the instruments for the detection of any mental disorder as well as of depressive and anxiety disorders was analyzed with receiver-operating characteristics analyses.

Results

The HADS performed better in all analyses compared to the GHQ-12. Best screening results with the HADS total scale were achieved for depressive disorders with an area under the curve of 0.82, a sensitivity of 74%, a specificity of 80%, and a misclassification rate of 21% (cutoff point=18). The positive predictive value is best (44%) for the detection of any mental disorder, with a cutoff point of 17.

Conclusions

The HADS total scale can be recommended as a valid screening instrument for the detection of comorbid mental disorders in patients with chronic somatic diseases. The use of the single HADS subscales has no advantage for screening performance.
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Metadata
Title
Screening for mental disorders in cancer, cardiovascular and musculoskeletal diseases
Comparison of HADS and GHQ-12
Authors
Martin Härter, MD, PhD
Sonja Woll
Alexandra Wunsch
Jürgen Bengel
Katrin Reuter, PhD
Publication date
01-01-2006
Publisher
Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 1/2006
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-005-0992-0

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