title: Somatic symptom overlap in Beck Depression Inventory-II scores following myocardial infarction.
abstract: BACKGROUND
  Depression measures that include somatic symptoms may inflate severity estimates among medically ill patients, including those with cardiovascular disease.
  
  
  OBJECTIVE
  To evaluate whether people receiving in-patient treatment following acute myocardial infarction (AMI) had higher somatic symptom scores on the Beck Depression Inventory-II (BDI-II) than a non-medically ill control group matched on cognitive/affective scores.
  
  
  METHODS
  Somatic scores on the BDI-II were compared between 209 patients admitted to hospital following an AMI and 209 psychiatry out-patients matched on gender, age and cognitive/affective scores, and between 366 post-AMI patients and 366 undergraduate students matched on gender and cognitive/affective scores.
  
  
  RESULTS
  Somatic symptoms accounted for 44.1% of total BDI-II score for the 209 post-AMI and psychiatry out-patient groups, 52.7% for the 366 post-AMI patients and 46.4% for the students. Post-AMI patients had somatic scores on average 1.1 points higher than the students (P<0.001). Across groups, somatic scores accounted for approximately 70% of low total scores (BDI-II <4) v. approximately 35% in patients with total BDI-II scores of 12 or more.
  
  
  CONCLUSIONS
  Our findings contradict assertions that self-report depressive symptom measures inflate severity scores in post-AMI patients. However, the preponderance of somatic symptoms at low score levels across groups suggests that BDI-II scores may include a small amount of somatic symptom variance not necessarily related to depression in post-AMI and non-medically ill respondents.
authors.affiliation: Department of Psychiatry, McGill University, and Department of Psychiatry and Center for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montréal, Québec, Canada. brett.thombs@mcgill.ca
authors.forename: Brett D
authors.initials: BD
authors.lastname: Thombs
authors.forename: Roy C
authors.initials: RC
authors.lastname: Ziegelstein
authors.forename: Louise
authors.initials: L
authors.lastname: Pilote
authors.forename: David J A
authors.initials: DJ
authors.lastname: Dozois
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Beck
authors.forename: Keith S
authors.initials: KS
authors.lastname: Dobson
authors.forename: Samantha
authors.initials: S
authors.lastname: Fuss
authors.forename: Peter
authors.initials: P
authors.lastname: de Jonge
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Grace
authors.forename: Donne E
authors.initials: DE
authors.lastname: Stewart
authors.forename: Johan
authors.initials: J
authors.lastname: Ormel
authors.forename: Susan E
authors.initials: SE
authors.lastname: Abbey
mesh_terms: D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000209:etiology; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology; D009203:Myocardial Infarction / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D013334:Students / Q000523:psychology