Assessing depression in the cardiac patient. When is the appropriate time to assess depression in the patient undergoing coronary revascularization?
Depression is a well-established risk factor for cardiovascular disease-related morbidity and mortality. It is common to screen for depression in patients undergoing coronary revascularization prior to revascularization; however, the validity of this assessment is unclear as some patients may experience transient, reactive depression rather than persistent depression. The authors evaluated whether an initial or 1-month postprocedure screen was optimal for identifying consistently depressed patients. Depression at 1-month postprocedure was a stronger predictor of depression at months 2 to 6 than baseline depression. After adjusting potential confounding variables, there was a much stronger relationship between 1-month and 6-month depression status (OR = 28.7 if depressed at 1 month, p < .001) than between baseline and 6-month depression status (OR = 6.5 if depressed at baseline, p < .001). Screening for depression at the time of revascularization is not as predictive of depression at 6 months as it is 1 month postprocedure.
Poston
Walker S Carlos
WS
Mid America Heart Institute, University of Missouri-Kansas City, USA. postonwa@umke.edu
Haddock
C Keith
CK
Conard
Mark W
MW
Jones
Phillip
P
Spertus
John
J
D000359:Aftercare / Q000592:standards; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000523:psychology / Q000534:rehabilitation; D002318:Cardiovascular Diseases / Q000150:complications / Q000523:psychology / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000523:psychology / Q000534:rehabilitation; D003863:Depression / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D008923:Missouri; D009204:Myocardial Revascularization / Q000523:psychology* / Q000534:rehabilitation; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013997:Time Factors