title: Specific fatigue-related items in self-rating depression scales do not bias an association between depression and fatigue in patients with coronary artery disease.
abstract: OBJECTIVE
  Self-rating instruments for depression include questions targeting fatigue, which is a common symptom of coronary artery disease (CAD) patients. We evaluated if specific fatigue-related questions in self-reported instruments of depression bias an association between fatigue and depression in CAD patients.
  
  
  METHODS
  A total of 1470 CAD patients attending cardiac rehabilitation program were evaluated for fatigue using the Multidimensional Fatigue Inventory (MFI-20) and for symptoms of depression using the depression subscale of the Hospital Anxiety and Depression scale (HADS-D) and the Beck Depression Inventory-II (BDI-II).
  
  
  RESULTS
  There was moderate correlation in MFI-20 scores vs. HADS-D scores and in MFI-20 scores vs. BDI-II scores, with stronger association in patients with less severe heart failure when compared to patients with more severe heart failure. Removal of questions targeting fatigue from the HADS-D and the BDI-II did not significantly change the association.
  
  
  CONCLUSIONS
  Fatigue-related items should not be removed from the HADS-D and the BDI-II when evaluating CAD patients for depressive symptoms.
authors.affiliation: Institute of Psychophysiology and Rehabilitation, Lithuanian University of Health Sciences, Palanga, Lithuania. a.bunevicius@yahoo.com
authors.forename: Adomas
authors.initials: A
authors.lastname: Bunevicius
authors.forename: Julija
authors.initials: J
authors.lastname: Brozaitiene
authors.forename: Albinas
authors.initials: A
authors.lastname: Stankus
authors.forename: Robertas
authors.initials: R
authors.lastname: Bunevicius
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D005221:Fatigue / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012647:Self-Assessment