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Psychiatry Investig > Volume 20(5); 2023 > Article
Psychiatry Investigation 2023;20(5):395-407.
DOI:    Published online May 25, 2023.
Psychometric Properties of Assessment Tools for Depression, Anxiety, Distress, and Psychological Problems in Breast Cancer Patients: A Systematic Review
Heeseung Park1,2  , Kyoung-Eun Kim1,2  , Eunsoo Moon2,3,4  , Taewoo Kang1,2 
1Breast Cancer Clinic, Busan Cancer Center, Pusan National University Hospital, Busan, Republic of Korea
2Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
3Department of Psychiatry, Pusan National University, Busan, Republic of Korea
4Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
Correspondence: Eunsoo Moon ,Tel: +82-51-240-7303, Fax: +82-51-248-3648, Email:
Correspondence: Taewoo Kang ,Tel: +82-51-240-7281, Fax: +82-51-240-7746, Email:
Received: November 3, 2022   Revised: March 27, 2023   Accepted: March 19, 2023   Published online: May 25, 2023
Various and accurate psychiatric assessments in patients with breast cancer who frequently suffer from psychological problems due to long-term survivors are warranted. This systematic review aimed to investigate the current evidence on psychometric properties of psychiatric assessment for evaluating psychological problems in breast cancer patients.
This systematic review progressed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Four electronic databases such as Web of Science, PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature were searched. This study protocol was registered on Open Science Framework.
Of the 2,040 articles, 21 papers were finally included. Among them, only five studies showed the performance of psychiatric assessment tools. Among 13 assessment tools used in the selected articles, the Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), or Mini-Mental Adjustment to Cancer Scale was frequently used for the evaluation of psychological problems. The DT and Psychosocial Distress Questionnaire-Breast Cancer showed acceptable performances for the prediction of depression and anxiety assessed by the HADS.
This systematic review found psychiatric assessment tools with acceptable reliability and validity for breast cancer patients. However, comparative studies on reliability and validity of various scales are required to provide useful information for the selection of appropriate assessment tools based on the clinical settings and treatment stages of breast cancer. Joint research among the fields of psychiatry and breast surgery is needed for research to establish the convergent, concurrent, and predictive validity of psychiatric assessment tools in breast cancer patients.
Key words   Breast neoplasm; Psychiatry; Psychometrics; Systematic review
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