183533 Assessing Depression in Acute Coronary Syndrome Patients

Monday, October 27, 2008

Mayra Tisminetzky, MD, MPH , Pediatrics, University of Massachusetts, Shrewsbury, MA
Thomas J. McLaughlin, ScD , Departments of Pediatrics and Psychiatry, University of Massachusetts Medical School, Worcester, MA
Ruben Miozzo , Psychiatry, University of Massachusetts, Worcester, MA
Background: Depression is a prevalent disorder in patients with acute coronary syndromes (ACS), a recent review has documented use of assessment tools in research settings. This document is intended as a practical guide for primary care clinicians.

Aims: To examine the psychometric properties of the instruments utilized to assess depression in patients with ACS in primary care.

Methods: We identified studies published between 1990 and 2006 that used standardized validated questionnaires to assess depression.

Results: Of the studies reviewed, 85% assessed depression within a week of hospitalization for ACS. Sensitivity ranged from 75% in the Hospital Anxiety Depression Scale to 88% in the Beck Depression Inventory (BDI) and Patient Health Questionnaire (PHQ-9). Specificity ranged from 62 % for the Geriatric Depression Scale to 88% for the PHQ-9. While the BDI was the instrument most frequently used, the PHQ-9 that is a public domain instrument was the questionnaire with the highest sensitivity and specificity.

Conclusions: Evaluating depression in patients with ACS in clinical setting is complicated by the lack of uniform criteria in choosing appropriate instruments.

Learning Objectives:
To examine the psychometric properties of the instruments utilized to assess depression in patients with Acute coronary syndrome in primary care settings to enable clinicians to more comfortably identify depression and make a working diagnosis of a mood disturbance that has the potential for impacting care of accompanying cardiac disease.

Keywords: Chronic (CVD), Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: MD, MPH
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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