title: Depression screening after cardiac surgery: A six month longitudinal follow up for cardiac events, hospital readmissions, quality of life and mental health.
abstract: OBJECTIVE
  To report the 6-month longitudinal outcomes of routine depression screening in cardiac patients.
  
  
  METHODS
  Routine depression screening consisted of the Patient Health Questionnaire (PHQ) administered 30-days after cardiac surgery at the Flinders Medical Centre, South Australia. Complete data was obtained on 481 patients who were subdivided into three groups; depressed-cardiac control determined by current anti-depressant use or history of depression in medical records (n=90), depression screen-positives (PHQ≥10, n=46) and depression screen-negatives (PHQ≤9, n=345). These groups were re-assessed at 6 month follow-up for major adverse cardiac events (MACE), hospital readmission, quality of life (SF-12), symptomatic depression, and use of antidepressants, anxiolytics and psychotherapy.
  
  
  RESULTS
  By six-month follow-up the depression screen-positive group was at a higher risk of MACE (adjusted odds ratio [OR] 2.16; 95% confidence interval [CI] .98-4.74). The depression screen-positive group was also at a higher risk of depressed mood (PHQ scores ≥10: adjusted OR 6.54; 95% CI 3.16-13.53). The depression screen-positive group also reported significantly poorer QOL in five domains (all p<.001 with Bonferroni correction). The depression screen-positive group was more likely to be initiated on antidepressant and anxiolytic (ORs 5.89 and 4.74 respectively) at follow-up. The number needed to screen to achieve one additional depression remission case was 9 in the screen-positive group (versus the depression-control group).
  
  
  CONCLUSIONS
  Depression screening was associated with an increase in psychotropic medication use however depression, morbidity and quality of life remained poor at six months.
authors.affiliation: Cardiac Surgery Research, Department of Surgery, Flinders Medical Centre and Flinders University of South, Australia; INSERM U897 Equipe de Neuro-épidémiologie, Université de Bordeaux, France; Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany; Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide, Australia.
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Tully
authors.affiliation: Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany; Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Baumeister
authors.affiliation: Cardiac Surgery Research, Department of Surgery, Flinders Medical Centre and Flinders University of South, Australia.
authors.forename: Jayme S
authors.initials: JS
authors.lastname: Bennetts
authors.affiliation: Cardiac Surgery Research, Department of Surgery, Flinders Medical Centre and Flinders University of South, Australia.
authors.forename: Greg D
authors.initials: GD
authors.lastname: Rice
authors.affiliation: Cardiac Surgery Research, Department of Surgery, Flinders Medical Centre and Flinders University of South, Australia. Electronic address: Rob.Baker@health.sa.gov.au.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Baker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000523:psychology*; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000523:psychology / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D011788:Quality of Life
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents
keywords: Cardiac surgery; Coronary heart disease; Depression; Diagnosis; Health care; Quality assurance