{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T20:01:02Z","timestamp":1770321662781,"version":"3.49.0"},"reference-count":62,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2011,9,15]],"date-time":"2011-09-15T00:00:00Z","timestamp":1316044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001593","name":"Irish Cancer Society","doi-asserted-by":"crossref","award":["CRP08GAL"],"award-info":[{"award-number":["CRP08GAL"]}],"id":[{"id":"10.13039\/501100001593","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Brief screening tools may help clinicians in busy settings detect patients who are experiencing severe psychological distress. This study examined the performance of the Distress Thermometer (DT) and a two\u2010item depression screen [the Patient Health Questionnaire\u20102 (PHQ\u20102)] with a \u2018help\u2019 question in screening for distress and psychiatric morbidity among patients with advanced cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two hundred and five patients with advanced cancer completed the DT, the PHQ\u20102 and \u2018help\u2019 question and the Hospital Anxiety and Depression Scale and were interviewed using the Structured Clinical Interview for DSM\u2010IV (SCID). The performance of the screening tools was examined against the Hospital Anxiety and Depression Scale and the SCID.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, discrimination levels were comparable for the DT [area under the curve (AUC) 0.80\u20130.81] and the PHQ\u20102 (AUC 0.73\u20130.85). The DT performed best in detecting cases of distress and mood, anxiety or adjustment disorders (sensitivity 100%), but it had poor specificity (49\u201360%). The best performance in terms of combined sensitivity and specificity was the PHQ depression item versus the SCID (sensitivity 88%, specificity 73%). The inclusion of the \u2018help\u2019 question with the PHQ\u20102 resulted in high levels of specificity (\u226589%), but there was a significant drop in sensitivity (\u226454%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ultra\u2010brief screening tools offer an efficient means of identifying patients with advanced cancer with severe distress or psychiatric morbidity but are less effective at identifying non\u2010distressed individuals. Used in conjunction with a \u2018help\u2019 question, these tools can help clinicians identify patients who are both distressed and likely to accept professional support. 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