Rapid screening for major depression in post-myocardial infarction patients: an investigation using Beck Depression Inventory II items.
OBJECTIVE
To determine the ability of three questions from the Beck Depression Inventory II (BDI-II) to detect major depressive disorder (MDD) in a cohort of patients hospitalised for acute myocardial infarction (MI).


METHODS
Prospective observational study.


METHODS
Coronary care unit and cardiac step-down unit of an urban academic medical centre.


METHODS
131 post-MI patients within 72 h of symptom onset.


METHODS
Patients were administered the BDI-II and participated in a structured diagnostic interview for MDD. Three individual BDI-II items (regarding sadness, loss of interest and loss of pleasure) were examined individually and in two-question combinations to determine their ability to screen for MDD.


METHODS
Sensitivity, specificity, negative and positive predictive values and proportion of patients with MDD correctly identified.


RESULTS
The individual items and two-question combinations had good sensitivity (76-94%), specificity (70-88%) and negative predictive values (97-99%). Item 1 (sadness) performed the best of the individual items (48% with a positive response to the item had MDD; 3% with a negative response had MDD; over 80% of patients with MDD were correctly identified). A combination of questions about sadness and loss of interest performed best among the two-question combinations (37% with positive response had MDD v 1% with a negative response; 94% of patients with MDD were identified).


CONCLUSIONS
One to two questions regarding sadness and loss of interest serve as simple and effective screening tools for post-MI depression.
Huffman
J C
JC
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. jhuffman@partners.org
Smith
F A
FA
Blais
M A
MA
Beiser
M E
ME
Januzzi
J L
JL
Fricchione
G L
GL
D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000592:standards; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires