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Depressive symptoms in advanced cancer. Part 1. Assessing depression: the Mood Evaluation Questionnaire

Claire Sinnott

Department of Palliative Medicine, St Thomas' Hospital, London

Paul T Seed

Department of Public Health Sciences, Guy's, King's and St Thomas' School of Medicine, King's College London, London

Objective: A prospective cohort study evaluated the performance and acceptability of the cognitive based Mood Evaluation Questionnaire (MEQ) in assessing depressive symptoms over time in patients with advanced cancer. The structured clinical interview for DSM-III-R (SCID) and the single-item interview screening question were also administered.

Method: Forty-five advanced cancer patients were followed monthly for up to six interviews (108 interviews in total).

Results: The MEQ and SCID had moderate agreement (weighted kappa 0.52 over all interviews). At first interview, 26 (58%) patients were depressed using MEQ, seven (16%) of these severely. Attrition rates were high for subsequent interviews. The assessment process was considered positive by 92% patients, and acceptable as a single and repeat measure. Positive responses to MEQ questions about worthlessness, death and self-harm were strong predictors of current depressed mood.

Conclusion: The MEQ has potential as a useful alternative to SCID in assessing depressive symptoms in a palliative care population, and can be used by nonpsychiatric trained professionals. It is positively received by patients and acceptable as a repeat measure. Most patients appreciate being asked about their mood in depth, including questions around death and self harm.

Key Words: cancer • depression assessment • palliative care • prevalence • scale • validation

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