Use of the Zung Self-Rating Depression Scale in cancer patients: Feasibility as a screening tool

The feasibility, utility and reliability of the Zung Self-Rating Depression Scale (ZSDS) was examined in a large sample of ambulatory cancer patients. This tool and a brief 11-item version of the ZSDS (excluding nine items co ncerning somatic symptoms), which was developed during the course of the su rvey, were used to estimate the prevalence of self-reported depressive symp toms. Patient characteristics that may be associated with an increased risk of clinically significant depressive symptoms were also explored. Twenty-f ive ambulatory oncology clinics affiliated with Community Cancer Care, Inc. enrolled and surveyed 1109 subjects. The alpha coefficients for the ZSDS ( 0.84) and the Brief ZSDS (0.84) indicated high levels of internal consisten cy. The overall prevalence of clinically significant depressive symptoms as defined by the ZSDS was 35.9% and by the Brief ZSDS was 31.1%. The ZSDS an d the Brief ZSDS were highly correlated (r = 0.92). The medical and demogra phic variables most associated with clinically significant depressive sympt oms were more advanced stage of disease at time of diagnosis, lung cancer a s primary tumor type, higher ECOG rating (greater degree of physical disabi lity), and having been prescribed antidepressant medications. The high prev alence of depressive symptoms observed in this study is consistent with rat es found in other studies of self-report depression instruments in cancer p atients. The initial indicators of internal consistency and validity sugges t that the Zung SDS or the brief version may be useful screening tools to i dentify depressive symptoms in oncology patients. (C) 1998 John Wiley & Son s, Ltd.