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Validation of the distress and impact thermometer and the changes of mood during the first 6 months of treatment in gynecological cancer patients: a Kansai Clinical Oncology Group (KCOG)-G1103 prospective study

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To verify distress and impact thermometer (DIT) for screening emotional distress in gynecological cancer patients by Hospital Anxiety and Depression Scale total (HADS-T) as gold standard and to assess emotional changes by DIT and HADS-T.

Methods

A prospective study was conducted in newly diagnosed gynecological cancer patients during the peri-treatment period after the cancer diagnosis followed by 6-month. We defined a HADS-T score of ≥11 as being indicative of emotional distress.

Results

117 patients were enrolled between May 1, 2011 and March 31, 2012, and 95 were eligible. The median age was 54 years (range 31–77). (1) From the baseline to 3-month, distress (DIT-D) ≥4 with Impact (DIT-I) ≥2 exhibited sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) of 0.776 [95 % confidential interval (CI) 0.688, 0.850], 0.889 (95 % CI 0.824, 0.954), 0.868 (95 % CI 0.792, 0.949), and 0.808 (95 % CI 0.731, 0.886), respectively. (2) At 6-month, DIT-D ≥2 with DIT-I ≥1 exhibited sensitivity, specificity, PPV and NPV of 0.893 (95 % CI 0.778, 1), 0.825 (95 % CI 0.707, 0.942), 0.781 (95 % CI 0.638, 0.928), and 0.917 (95 % CI 0.826, 1). (3) At 6-month, the HADS-T, DIT-D, and DIT-I scores in individual patients were significantly reduced by a mean of 4.57 (p < 0.0001), 2.34 (p < 0.0001), and 1.10 (p = 0.0031), respectively, compared with those scores of baseline (Student’s paired t test), but still remained high.

Conclusions

(1) On acute phase within 3-month setting, DIT; DIT-D ≥4 with DIT-I ≥2, is a reliable cut-off to screen emotional distress among gynecological cancer patients. (2) The patients’ moods had improved, but not completely recovered at 6-month after the diagnosis.

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Fig. 1

Adapted Akizuki et al. [9]

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Acknowledgments

We would like to express our deep gratitude to Ken Shimizu for his valuable suggestions during the planning of this research.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Nara Prefecture General Medical Center, Nara, Japan

    Y. Itani

  2. Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medicine, Nagoya, Japan

    A. Arakawa & R. Nishikawa

  3. Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Japan

    H. Tsubamoto

  4. Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan

    K. Ito, S. Yamamoto & K. Hori

  5. Department of Obstetrics and Gynecology, Meiwa General Hospital, Amagasaki, Japan

    K. Inoue

  6. Department of Gynecology Okayama, Ohfuku Clinic, Okayama, Japan

    Y. Miyagi

  7. Department of Obstetrics and Gynecology, Nara Prefectural Seiwa Medical Center, Ikomagun-Sangocho, Japan

    N. Furukawa

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  1. Y. Itani
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Corresponding author

Correspondence to Y. Itani.

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Funding

This study was financed by KCOG’s (Kansai Clinical Oncology Group) own resources.

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of each institutional review board and KCOG institutional review board with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

404_2016_4166_MOESM1_ESM.pptx

Supplementary material 1 (PPTX 63 kb) Electronic Supplementary Material Table 1. (title) Distribution of registered patients (n = 115) of each institution (caption) A: Nara General Medical Center, B: Nagoya City University Hospital, C: Hyogo Medical College Hospital, D:Kansai Rosai Hospital

404_2016_4166_MOESM2_ESM.xls

Supplementary material 2 (XLS 82 kb) Electronic Supplementary Material Table 2. (title) Sensitivity, specificity, PPV, NPV, positive likelihood ratio, negative likelihood ratio, and sensitivity–(1-specificity) values observed each at DIT-D score and DIT-I score (caption) DIT: Distress and Impact Thermometer, CI: confidence interval, PPV: positive predictive value, NPV: negative predictive value, LR: likelihood ratio, DIT-D: distress score, DIT-I: impact score

404_2016_4166_MOESM3_ESM.pptx

Supplementary material 3 (PPTX 112 kb) Electronic Supplementary Material Fig. 1. (title) Correlation among HADS total, HADS distress, and HADS anxiety, (caption) Correlation coefficients between HADS-T and HADS-D; depression component of HADS, between HADS-T and HADS-A; anxiety component of HADS, and between HADS-D and HADS-A were 0.94, 0.94 and 0.764, respectively. R: Correlation coefficient

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Itani, Y., Arakawa, A., Tsubamoto, H. et al. Validation of the distress and impact thermometer and the changes of mood during the first 6 months of treatment in gynecological cancer patients: a Kansai Clinical Oncology Group (KCOG)-G1103 prospective study. Arch Gynecol Obstet 294, 1273–1281 (2016). https://doi.org/10.1007/s00404-016-4166-y

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