title: Validity of the European Society of Cardiology's Psychosocial Screening Interview in Patients With Coronary Artery Disease-The THORESCI Study.
abstract: OBJECTIVE
  The aim of the study was to examine the validity of the European Society of Cardiology (ESC) psychosocial screening instrument.
  
  
  METHODS
  A total of 508 acute (67%) or elective (33%) percutaneous coronary intervention patients (mean [standard deviation]age = 63 [10] years, 81% male) completed the ESC screening interview and established questionnaires for psychosocial risk markers, that is, depression (Patient Health Questionnaire 9), anxiety (Generalized Anxiety Disorder Questionnaire 7), type D personality (Type D Scale 14), hostility (Cook-Medley Hostility Scale 7), and marital/work stress (Maudsley Marital Quality Questionnaire 6, Effort-Reward Imbalance Scale) during or close after hospital admission. At 1-year follow-up, angina and cardiopulmonary symptoms were assessed.
  
  
  RESULTS
  Prevalence estimates of psychosocial factors based on the ESC screener were as follows: depression (18%), anxiety (33%), negative affectivity (11%), social inhibition (41%), work stress (17%), marital stress (2%), and hostility (38%). Analysis of correspondence with validated questionnaires revealed fair to moderate agreement (depression [κ = .39], anxiety [κ = .23], type D personality [κ = .21]), regardless of percutaneous coronary intervention indication. For work and marital stress, there was poor to fair performance (κ range = .04-.24); agreement for hostility was poor (κ = -.27). A positive ESC screen for depression, anxious tension, and type D personality was associated with more angina and cardiopulmonary symptoms at follow-up (odds ratios ranging between 1.85 (95% confidence interval = 0.84-4.08) and 8.01 (95% confidence interval = 2.35-27.35).
  
  
  CONCLUSIONS
  The ESC screener contributes to the search for a multidimensional and easy-to-use psychosocial screening instrument for cardiac patients. Although the screener, in its current form, may not be sufficiently valid to reliably detect all predefined psychosocial factors, screening scores for depression and anxiety might be useful in clinical practice. Our findings can be used for further refinement and validation of the screener.
authors.affiliation: From the CoRPS - Center of Research on Psychological and Somatic Disorders (van Montfort, Denollet, Widdershoven), Tilburg University; and Elisabeth Tweesteden Hospital (Widdershoven), Tilburg, the Netherlands.
authors.forename: Eveline
authors.initials: E
authors.lastname: van Montfort
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
authors.forename: Jos
authors.initials: J
authors.lastname: Widdershoven
authors.forename: Nina
authors.initials: N
authors.lastname: Kupper
mesh_terms: D000339:Affect; D001007:Anxiety / Q000150:complications; D003324:Coronary Artery Disease / Q000209:etiology / Q000523:psychology*; D003863:Depression / Q000150:complications; D054541:Family Conflict / Q000523:psychology; D005260:Female; D006791:Hostility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D000073397:Occupational Stress / Q000150:complications; D011584:Psychology; D015203:Reproducibility of Results; D012307:Risk Factors; D012917:Social Adjustment; D064415:Type D Personality