title: Using a patient-generated mental-health measure 'PSYCHLOPS' to explore problems in patients with coronary heart disease.
abstract: BACKGROUND
  Patients with coronary heart disease (CHD) who are depressed have an increased risk of further cardiac events and higher mortality.
  
  
  OBJECTIVE
  To use a patient generated instrument (PSYCHLOPS) to define categories of concerns in patients with CHD. To define the psychometric characteristics of patients in each category.
  
  
  METHODS
  Cross-sectional study set in general practices in south London.
  
  
  METHODS
  Of 3325 patients on the CHD registers in 15 general practices, 655 completed six baseline psychometric and functional instruments: PSYCHLOPS, HADS-Depression, HADS-Anxiety, Clinical Interview Schedule-Revised, SF12-Mental and SF12-Physical. Content analysis was used to categorise patients based on their main problem, as elicited by PSYCHLOPS. Mean psychometric scores were adjusted for confounding by age, sex, deprivation and ethnicity and calculated for each response category.
  
  
  RESULTS
  Response categories were: physical problems, both non-cardiac (23.2%) and cardiac (6.0%); social problems: relationship/family (18.2%), money (7.5%), work (3.1%); functional (9.8%); psychological (6.9%); miscellaneous (7.3%); 'no problem' (18.2%). The highest psychological distress scores were found in 'physical, cardiac' and 'psychological' categories. The 'no problem' category had significantly lower psychological distress and higher functional capacity than other categories.
  
  
  CONCLUSIONS
  PSYCHLOPS enabled the identification of subtypes of CHD patients, based on a classification of self-reported problems. A high proportion of CHD patients report social problems. Psychological distress was highest in those reporting cardiac or psychological symptoms. Services should be aligned to the reported needs of patients.
authors.affiliation: Research assistant, Institute of Psychiatry, King's College London, London.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lawton
authors.affiliation: Division of Women's Health, King's College London School of Medicine, London.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Seed
authors.affiliation: Department of Primary Care Public Health Sciences, King's College London School of Medicine, London.
authors.forename: Maria
authors.initials: M
authors.lastname: Kordowicz
authors.affiliation: Research fellow, Department of Primary Care Public Health Sciences, King's College London School of Medicine, London.
authors.forename: Peter
authors.initials: P
authors.lastname: Schofield
authors.affiliation: Institute of Psychiatry, King's College London, London.
authors.forename: André
authors.initials: A
authors.lastname: Tylee
authors.affiliation: Department of Primary Care Public Health Sciences, King's College London School of Medicine, London.
authors.forename: Mark
authors.initials: M
authors.lastname: Ashworth
mesh_terms: D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D058006:General Practice / Q000379:methods*; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008131:London; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D018570:Risk Assessment; D057566:Self Report; D012720:Severity of Illness Index; D017678:Sex Distribution; D018434:Sickness Impact Profile; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D015996:Survival Rate; D014505:Urban Population
keywords: coronary heart disease; functional capacity measures; mental health outcome measures; patient-generated outcome measures; primary care