How do we interpret the answer "Neither" when physicians ask patients with cancer "Are you depressed or not?".

Abstract

The aim of this study was to clarify how physicians should interpret the answer "neither" to the single-question interview, "Are you depressed or not?" Two hundred fifty-one patients with cancer were studied. The patients were directly interviewed, choosing one answer among these three: "Yes, I am depressed"; "No, I am not depressed"; or "Neither." After this, the patients completed the Hospital Anxiety and Depression Scale (HADS). The threshold of 11 or greater on HADS was used for adjustment disorder and major depressive disorder. All patients could reply to the single question, but 10 patients did not complete HADS. Among 83, 81 and 77 patients who answered "yes," "neither," and "no," respectively, 75 (90%), 43 (65%), and 9 (12%) patients scored 11 or more on HADS. The mean score of HADS was 12.2 in patients who answered "neither," significantly higher than that of the "no" group (p < 0.0001) and significantly lower than that of the "yes" group (p < 0.0001). Patients who answered "neither" frequently scored in a high enough range to warrant further investigation for adjustment or depressive disorder.