title: Single-item measures for depression and anxiety: Validation of the Screening Tool for Psychological Distress in an inpatient cardiology setting.
abstract: BACKGROUND
  Depression and anxiety are common among patients with cardiovascular disease (CVD) and confer significant cardiac risk, contributing to CVD morbidity and mortality. Unfortunately, due to the lack of screening tools that address the specific needs of hospitalized patients, few cardiac inpatient programs offer routine screening for these forms of psychological distress, despite recommendations to do so.
  
  
  OBJECTIVE
  The purpose of this study was to validate single-item measures for depression and anxiety among cardiac inpatients.
  
  
  METHODS
  Consecutive inpatients were recruited from the cardiology and cardiac surgery step-down units at a university-affiliated, quaternary-care hospital. Subjects completed a questionnaire that included: (a) demographics, (b) single-item-measures for depression and anxiety (from the Screening Tool for Psychological Distress (STOP-D)), and (c) Hospital Anxiety and Depression Scale (HADS).
  
  
  RESULTS
  One hundred and five participants were recruited with a wide variety of cardiac diagnoses, having a mean age of 66 years, and 28% were women. Both STOP-D items were highly correlated with their corresponding validated measures and demonstrated robust receiver-operator characteristic curves. Severity scores on both items correlated well with established severity cut-off scores on the corresponding subscales of the HADS.
  
  
  CONCLUSIONS
  The STOP-D is a self-administered, self-report measure using two independent items that provide severity scores for depression and anxiety. The tool performs very well compared with other previously validated measures. Requiring no additional scoring and being free, STOP-D offers a simple and valid method for identifying hospitalized cardiac patients who are experiencing psychological distress. This crucial first step triggers initiation of appropriate monitoring and intervention, thus reducing the likelihood of the adverse cardiac outcomes associated with psychological distress.
authors.affiliation: Heart Centre, St. Paul's Hospital, Canada Qyoung@providencehealth.bc.ca.
authors.forename: Quincy-Robyn
authors.initials: QR
authors.lastname: Young
authors.affiliation: Heart Centre, St. Paul's Hospital, Canada.
authors.forename: Michelle
authors.initials: M
authors.lastname: Nguyen
authors.affiliation: Heart Centre, St. Paul's Hospital, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Roth
authors.affiliation: Heart Centre, St. Paul's Hospital, Canada.
authors.forename: Ann
authors.initials: A
authors.lastname: Broadberry
authors.affiliation: Heart Centre, St. Paul's Hospital, Canada Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Canada.
authors.forename: Martha H
authors.initials: MH
authors.lastname: Mackay
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D019540:Area Under Curve; D002170:Canada; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011594:Psychometrics; D012372:ROC Curve; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires
keywords: Depression; anxiety; assessment; cardiac; inpatient; screening; single-item measures