Objectives: 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?"
Patients and methods: 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.
Results: 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).
Conclusion: Patients who answered "neither" frequently scored in a high enough range to
warrant further investigation for adjustment or depressive disorder.
