title: Base Rates of Depressive Symptoms in Patients with Coronary Heart Disease: An Individual Symptom Analysis.
abstract: BACKGROUND
  Major depression is common in coronary heart disease (CHD) but challenging to diagnose. Instead of focusing on the overall diagnosis of depression, base rates of depressive symptoms could facilitate screening and management of psychopathology in CHD. The present study investigates the frequency of individual depressive symptoms in CHD and their impact on cardiac and subjective health.
  
  
  METHODS
  In total, 1337 in- and outpatients with CHD were screened for depressive symptoms with the Patient Health Questionnaire-9 (PHQ-9) at three different cardiac treatment sites. Tables stratified by age and gender were designed to illustrate base rates of depressive symptoms. Multiple regression analyses adjusted for sociodemographic and clinical data were conducted to test associations between individual depressive symptoms and quality of life as well impairment caused angina pectoris and dyspnea.
  
  
  RESULTS
  During the last 14 days, more than half of patients reported a loss of energy (74.9%, 95% Confidence Interval (CI): 70.6-79.2), sleeping problems (69.4%, 95% CI: 64.9-74.0), loss of interest (55.7%, 95% CI: 50.8-60.7). In contrast, psychomotor change (25.6%, 95%CI: 21.3-30.0), feelings of failure (21.9%, 95%CI: 17.7-26.0), suicidal ideations (14.1%, 95%CI: 10.7-17.6) were less frequently reported. Depending on the outcome, only particular depressive symptoms were highly associated with low quality of life and impairment caused by angina pectoris and dyspnea. Loss of energy was the only depressive symptom that reliably predicted all three outcomes.
  
  
  CONCLUSIONS
  Depressive symptoms in CHD are frequent but vary widely in terms of frequency. Findings underline the differential effects of individual depressive symptoms on cardiac health. Presented base rates of depressive symptoms offer clinicians a new way to judge the severity of individual depressive symptoms and to communicate individual PHQ-9 profiles with patients with respect to gender, age, cardiac symptoms and quality of life.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, and Schön Clinic Hamburg-Eilbek, Hamburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kohlmann
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, and Schön Clinic Hamburg-Eilbek, Hamburg, Germany.|Department of Psychiatry, Asklepios Clinic North Ochsenzoll, Hamburg, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Gierk
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, and Schön Clinic Hamburg-Eilbek, Hamburg, Germany.
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Murray
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, and Schön Clinic Hamburg-Eilbek, Hamburg, Germany.
authors.forename: Arne
authors.initials: A
authors.lastname: Scholl
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, and Schön Clinic Hamburg-Eilbek, Hamburg, Germany.
authors.forename: Marco
authors.initials: M
authors.lastname: Lehmann
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, and Schön Clinic Hamburg-Eilbek, Hamburg, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Löwe
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000150:complications* / Q000523:psychology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires