Using the Short Form-36 mental summary score as an indicator of depressive symptoms in patients with coronary heart disease.
BACKGROUND
Depression is common in patients with cardiac disease; however, the use of depression-specific health instruments is limited by their increased responder and analyst burden. The study aimed to define a threshold value on the Short Form-36 (SF-36) mental component summary score (MCS) that identified depressed cardiac patients as measured by the Centre for Epidemiologic Studies Depression Scale (CES-D).


METHODS
An optimal threshold was determined using receiver-operating characteristic (ROC) curves on SF-36 and CES-D data from a large cardiac cohort (N = 1,221). The performance of this threshold was evaluated in a further two cardiac populations.


RESULTS
In the index cohort, an SF-36 MCS score of ≤45 was revealed as an optimal threshold according to maximal Youden Index, with high sensitivity (77%, 95% CI = 74-80%) and specificity (73%, 95% CI = 69-77%). At this threshold, in a second sample of hospital cardiac patients, sensitivity was 93% (95% CI = 76-99%) and specificity was 64% (95% CI = 49-77%). In a final sample generated from a community population, specificity was 100% (95% CI = 85-100%) and sensitivity was 68% (95% CI = 61-74%) at the cut-off of 45.


CONCLUSIONS
The SF-36 MCS may be a useful research tool to aid in the classification of cardiac patients according to the presence or absence of depressive symptoms.
Tavella
Rosanna
R
Cardiology Research Unit, The Queen Elizabeth Hospital, University of Adelaide, 28 Woodville Rd, Woodville South, 5011 Adelaide, SA, Australia. rosanna.tavella@adelaide.edu.au
Air
Tracy
T
Tucker
Graeme
G
Adams
Robert
R
Beltrame
John F
JF
Schrader
Geoffrey
G
D000368:Aged; D015331:Cohort Studies; D003327:Coronary Disease / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012016:Reference Values; D012680:Sensitivity and Specificity
Am Heart J. 2003 Dec;146(6):978-84
14660988
Am J Psychiatry. 1982 Jun;139(6):799-802
7081496
J Clin Epidemiol. 1998 Jul;51(7):569-75
9674663
Am J Epidemiol. 1987 Apr;125(4):672-8
3826045
J Clin Epidemiol. 1998 Nov;51(11):903-12
9817107
Aust J Public Health. 1995 Apr;19(2):160-6
7786942
Int J Psychiatry Med. 1990;20(3):259-77
2265888
J Am Geriatr Soc. 1994 Oct;42(10):1103-9
7930337
Med J Aust. 2005 Mar 21;182(6):272-6
15777141
J Cardiovasc Risk. 2001 Aug;8(4):219-25
11551000
Arch Gen Psychiatry. 1985 Dec;42(12):1164-70
4074109
Circulation. 2002 Jul 2;106(1):43-9
12093768
Arch Gen Psychiatry. 2001 Mar;58(3):221-7
11231827
J Clin Epidemiol. 2004 Oct;57(10):1096-103
15528061
Epidemiol Perspect Innov. 2006 Apr 12;3:4
16608529
Int J Psychiatry Med. 1988;18(2):169-81
3170080
JAMA. 1989 Aug 18;262(7):914-9
2754791
Cancer. 1950 Jan;3(1):32-5
15405679
Am J Psychiatry. 1983 Jan;140(1):41-6
6847983
Spine J. 2006 May-Jun;6(3):316-20
16651227
Psychosom Med. 2003 Mar-Apr;65(2):201-10
12651987
JAMA. 2003 Jun 18;289(23):3106-16
12813116
Am Fam Physician. 1990 Mar;41(3):897-904
2407078
Psychosomatics. 2001 Sep-Oct;42(5):423-8
11739910
Am J Epidemiol. 1977 Sep;106(3):203-14
900119
J Gen Intern Med. 2000 May;15(5):301-10
10840265
Med Care. 1993 Mar;31(3):247-63
8450681
Am J Epidemiol. 1998 May 15;147(10):969-77
9596475
J Affect Disord. 2004 Jul;81(1):61-6
15183601
JAMA. 2002 Aug 14;288(6):701-9
12169073
Eur J Epidemiol. 2000 Apr;16(4):311-6
10959937
Heart. 2000 Oct;84(4):390-4
10995407
Int J Epidemiol. 2009 Dec;38(6):1479-86
19074192
Am J Epidemiol. 2004 Dec 15;160(12):1152-8
15583367
J Consult Clin Psychol. 1984 Oct;52(5):892-8
6501675
Biom J. 2005 Aug;47(4):458-72
16161804
J Clin Epidemiol. 1991;44(8):779-86
1941029
Gen Hosp Psychiatry. 2007 Sep-Oct;29(5):417-24
17888808
J Clin Epidemiol. 2000 Apr;53(4):359-65
10785566
Med Care. 1991 Feb;29(2):169-76
1994148
Med Care. 1995 Apr;33(4 Suppl):AS264-79
7723455
Pain Med. 2003 Dec;4(4):331-9
14750909