'A no means no'--measuring depression using a single-item question versus Hospital Anxiety and Depression Scale (HADS-D).

BACKGROUND: Depression often develops undetected; to make treatment possible, a single-item screening question may be useful. PATIENTS AND METHODS: We attempted to compare the accuracy of the single-item question 'Are you depressed?' with the seven-item Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) among 1192 Swedish testicular cancer survivors. RESULTS: We obtained information from 974 men (82%). Fifty-nine men (6%) answered 'Yes' to the question 'Are you depressed?' while 118 (12%) answered 'I don't know' and 794 (82%) answered 'No'. Among the 794 men who answered 'No' to the question 'Are you depressed?', 790 (99.5%) were not considered as depressed according to HADS-D 11+. Of those answering 'Yes', 34% (20/59) were identified as depressed according to the same cut-off. Sensitivity of 'Yes' compared with HADS-D > or =11 was 61%, rising to 88% when 'Yes' and 'I don't know' were combined. CONCLUSION: In a population of men with a prevalence of depression similar to that of the normal population, almost none of those responding 'No' to the written question 'Are you depressed?' were depressed according to HADS-D > or =11. Adding the category 'I don't know' increases sensitivity in detecting depression.

Health care-related predictors of husbands' preparedness for the death of a wife to cancer--a population-based follow-up.

BACKGROUND: If we can learn how to increase preparedness before the death of a loved one, we can possibly decrease the next-of-kin's long-term morbidity. METHODS: In a population-based study, 691 of 907 (76%) men in Sweden who lost a wife to cancer 4-5 years earlier answered an anonymous questionnaire about their preparedness at the time of their wife's death as well as potential predictors for preparedness. RESULTS: A final logistic regression model indicates following predictors for preparedness, among others: the length of the widower's intellectual awareness time before his wife's death [relative risk (RR) 4.1, confidence interval (CI) 2.7-6.1], the widower could take in the information that his wife's disease could not be cured (RR 3.5, CI 2.3-5.2), the couple had arranged their economical affairs (RR 1.5, CI 1.3-1.7), the wife had stayed at a palliative care unit during her last months of life (RR 1.2, CI 1.1-1.4) and health care personnel supported the husband to participate in his wife's care (RR 1.6, CI 1.3-2.1). CONCLUSIONS: We identified several care-related factors that may influence the preparedness of men before their wife's death to cancer. These factors can be considered in future intervention studies aiming at influencing preparedness before the death of a loved one.