From: "Dr. D. Kossove" <doctordee@telkomsa.net>
To: "lmS List"; "acc List"; "rare Cancer List"; "lif List"
Subject: Major depression in outpatients attending a regional cancer centre
Date: Tuesday, January 20, 2004 11:13 AM


Add to this 8% below, the 16% of patients who have received chemotherapy who have undiagnosed thyroid disorders, and you have a very tired, sad sack group of patients..

If you are depressed or unreasonably tired...  get T4 and TSH done [hypothyroidism can mask as depression] as well as blood counts when you discuss this with your doctor.

doreen
Together we are more, and more effective, than we are separately.

All correspondence is my personal opinion.  I am not an oncologist.  I am not practicing medicine online.  Provision of information is for investigation and discussion with your doctors.


British Journal of Cancer (2004) 90, 314-320. 
doi:10.1038/sj.bjc.6601578 

Major depression in outpatients attending a regional cancer centre: screening and unmet treatment needs

M Sharpe1, V Strong1, K Allen2, R Rush3, K Postma2, A Tulloh2, P Maguire4, A House5, A Ramirez6 and A Cull2

1Division of Psychiatry, School of Molecular and Clinical Medicine, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, UK

2Cancer Research UK Psychological Medicine Research Group, Cancer Research Centre, Western General Hospital, Crewe Road, Edinburgh. EH4 2XR, UK

3Cancer Research UK, Edinburgh Oncology Unit, Western General Hospital, Crewe Road, Edinburgh EH4 2XR, UK

4Cancer Research Campaign Psychological Medicine Group, Christie Hospital NHS Trust, Stanley House, Wilmslow Road, Withington, Manchester M20 4BX, UK

5School of Medicine, University of Leeds, 15 Hyde Terrace, Leeds LS2 9LT, UK

6Department of Liaison Psychiatry and Cancer Research UK London Psychosocial Group, Adamson Centre for Mental Health, South Wing, St Thomas' Hospital, London SE1 7EH, UK



Correspondence to: Dr M Sharpe, Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, UK. E-mail: michael.sharpe@ed.ac.uk

Received 13 December 2002; revised 22 September 2003; accepted 24 October 2003



A screening programme designed to identify cases of Major Depressive Disorder (MDD) in patients attending a Regional Cancer Centre outpatient department was established. It comprised two stages: (1) The Hospital Anxiety and Depression Scale (HADS) self-rating questionnaire administered by a touch-screen computer; (2) we interviewed patients with high scores on the HADS (15 or more total score) over the telephone using the depression section of the Structured Clinical Interview for DSMIV (SCID). A large consecutive sample (5613) of oncology clinic attenders was screened, and practical difficulties in the screening process were identified. The estimated prevalence of major depressive disorder (MDD) in the sample surveyed was approximately 8% (7.8%; 95% confidence intervals 6.9-8.5%). We assessed a consecutive series of 150 patients identified as having MDD to determine how many had received evidence-based treatment for MDD. Only half had discussed their low mood with their general practitioner, only one-third had been prescribed any antidepressant medication, and very few had taken a therapeutic dose for an adequate period. Very few had received psychological treatment or had been referred to mental health services. Most were receiving no potentially effective therapy.

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