Detection of depression in cardiac inpatients: feasibility and results of systematic screening.
BACKGROUND
A recent American Heart Association (AHA) Prevention Committee report recommended depression screening of all coronary heart disease patients using 2- and 9-item instruments from the Patient Health Questionnaire (PHQ-2 and PHQ-9) to identify patients who may need further assessment and treatment. Our objective was to assess the feasibility and results of such screening on inpatient cardiac units.


METHODS
In September 2007, the PHQ-2 was added to the nursing interview dataset on 3 cardiac units in a general hospital; this screen was completed as part of routine clinical care. Rates and results of depression screening, reasons for patients not being screened, and results of a nursing satisfaction survey were tabulated, and differences in baseline characteristics between screened and unscreened patients were analyzed via chi(2) and independent-samples t tests.


RESULTS
For a 12-month period, 4,783 patients were admitted to the cardiac units; 3,504 (73.3%) received PHQ-2 depression screening. Approximately 9% of screened patients had a PHQ-2 score > or =3 and were approached for further depression evaluation (PHQ-9) by a social worker; 74.1% of the positive-screen patients had a PHQ-9 score of > or =10, suggestive of major depression. Nurses (n = 66) reported high satisfaction with the screening process, and mean reported PHQ-2 screening time was 1.4 (+/-1.1) minutes.


CONCLUSIONS
Systematic depression screening of cardiac patients using methods outlined by the AHA Prevention Committee is feasible, well-accepted, and does not appear markedly resource-intensive. Future studies should link these methods to an efficient and effective program of depression management in this vulnerable population.
Sowden
Gillian
G
Harvard Medical School, Boston, MA, USA.
Mastromauro
Carol A
CA
Januzzi
James L
JL
Fricchione
Gregory L
GL
Huffman
Jeff C
JC
D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005240:Feasibility Studies; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology*; D006801:Humans; D007297:Inpatients; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D011795:Surveys and Questionnaires