Prevalence of mood disorders and utility of the PRIME-MD in patients undergoing radiation therapy

Purpose: To validate a short, structured interview procedure that allows pr acticing oncologists to quickly and reliably identify mood disorders in the ir patients, and to estimate the prevalence and types of mood disorders in a radiation therapy patient setting, noting relationships between mood diso rders and patient characteristics. Methods: Consecutive, eligible adult patients from the practices of two rad iation oncologists were administered the Primary Care Evaluation of Mental Disorders (PRIME-MD) by the treating physician. A subset of these patients was also evaluated with the SCID, administered by trained mental health car e personnel. Agreement between the two instruments was examined using the k appa statistic. Prevalence of mood disorders was determined from the PRIME- MD. The significance of relationships between patient characteristics and m ood disorders was examined by chi-square and ANOVA analysis, and subsequent ly by multivariate logistic regression analysis. Results: One hundred twenty-two patients were studied. Fifty-three of these were administered the SCID. Agreement between the two instruments was very good (kappa = 0.70). A diagnosis of a depressive or anxiety disorder by th e PRIME-MD was made in 59 of the 122 patients (48%, 95% confidence interval = 39%, 58%). Multivariate analysis showed that a diagnosis of a depressive mood disorder was significantly related to pain intensity and prior histor y of depression. Conclusion: We have demonstrated the validity and feasibility of the PRIME- MD administered by oncologists in making-diagnoses of mood disorders. The p revalence of mood disorders in our set of patients undergoing a course of R T was nearly 50%. Future studies should describe the natural history of the se disorders, and determine optimal intervention strategies. (C) 1998 Elsev ier Science Inc.