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Detecting depression after acute myocardial infarction and unstable angina using the Beck Depression Inventory - II and the Geriatric Depression Scale Low, Gail Dianne

Abstract

No validation studies have been conducted with the Beck Depression Inventory - Second Edition (BDI-II) or the Geriatric Depression Scale (GDS) in a cardiac population. Because depression is an independent risk factor for mortality in cardiac patients, it is essential to identify a depression screen that is appropriate for this group. A total of 119 patients (89 men and 30 women) were recruited from the coronary care units of three hospitals. Home interviews were conducted approximately 2 weeks post-myocardial infarction (MI) or post-unstable angina/acute coronary syndrome (UA/ACS) . Participants were screened for depressive symptoms using the BDI-II and GDS. Research diagnoses o f participants' depression were determined using, as a gold standard, the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP) criteria for depression. Reliability estimates for both BDI-II and GDS scores were satisfactory. Criterion-related validity was examined by comparing the scores obtained on the BDI-II and GDS with the SCID-I/NP diagnoses of depression. Sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were evaluated for different cut scores for the BDI-II and GDS, using receiver operating characteristic (ROC) curves. ROC curves revealed that both the BDI-II and GDS demonstrated excellent sensitivity for detecting major depressive disorder and double depression, however, the GDS demonstrated greater specificity and PPV than the BDI-II with this sample. For this population of medically-ill, older adults, it is recommended that researchers and clinicians use the GDS to screen for major depressive disorder or double depression. Neither the BDI-II nor the GDS was effective in screening for the broader or milder forms of depression (i.e., minor depressive disorder, partial remission of major depressive disorder, or dysthymia) in this post-MI and post-UA/ACS sample.

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