VHRM-29424-the-predictive-power-of-depression-screening-procedures-for-_041612.pdf (153.31 kB)
The predictive power of depression screening procedures for veterans with coronary artery disease
journal contribution
posted on 2013-12-03, 00:00 authored by Stewart A. Shankman, Jeffrey Nadelson, Sarah Kate McGowan, Ali A. Sovari, Mladen I. VidovichDepression leads to a worse outcome for patients with coronary artery disease
(CAD). Thus, accurately identifying depression in CAD patients is imperative. In many veterans
affairs (VA) hospitals, patients are screened for depression once a year using the patient health
questionnaire
(PHQ-9). Although the PHQ-9 is generally considered a specific and sensitive
measure of depression, there is reason to believe that these screening procedures may miss a
large number of cases of depression within CAD patients and cardiology patients more generally.
The goal of this study was to provide data as to the predictive power of this depression screening
procedure by (a) comparing the prevalence rate of depression identified by the PHQ-9 to
known prevalence rates and (b) examining whether patients identified as “depressed” also
had conditions that consistently co-occur with depression (eg, post-traumatic stress disorder
[PTSD], other medical issues). Participants were 813 consecutive patients who received an
angiogram in the cardiac catheterization laboratory at a large VA Medical Center. Prevalence
of depression was 6.9% in the overall sample and less than 6% when the sample was restricted
to CAD patients with significant stenosis. Depression was significantly associated with PTSD,
smoking, and alcohol problems. However, depression was not associated with other medical
problems such as diabetes, renal failure, peripheral vascular disease, or anemia. In conclusion,
the low prevalence rate of depression and lack of associations with comorbid medical problems
may suggest that the VA’s depression screening procedures have low sensitivity for identifying
depression in CAD patients. It is recommended that clinicians treating CAD regularly screen
for depression and do not rely on archival depression screens.
History
Publisher Statement
This is a copy of an article published in the Vascular Health and Risk Management © 2012 Dove Medical Press. The final publication is available at http://www.dovepress.com/vascular-health-and-risk-management-journal. © 2012 Shankman et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.Publisher
Dove Medical PressLanguage
- en_US
issn
1178-2048Issue date
2012-04-01Usage metrics
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