Background:
Two issues arise in relation to depression in the cardiac population. The first is in relation to clinical practice, although depression is now recognized as a risk factor for increased morbidity and mortality in those with acute coronary syndrome (ACS) and, to a lesser degree, heart failure (HF). It remains underdiagnosed and undertreated in clinical practice. The second issue is a measurement issue: much of the research on depression in the cardiac population relies on measurement of depression symptoms with psychiatric rating scales and applies cut-offs for these scales that were predetermined for use in psychiatric rather than medical setting. This may lead to measurement errors as many of these scales include somatic symptoms. A well-validated screening and measurement tool specifically validated for use in this population may speak to both these issues, aiding detection and treatment of this important risk factor, as well as measuring it more accurately for research purposes.
Methods:
A total of 322 patients with ACS or HF completed the DMI measures, psychosocial questionnaires and a semistructured clinical interview during the hospital stay.
Results:
Both measures showed good psychometric properties, with high sensitivity and specificity when evaluated against clinical judgment. Cut-off points of ≥6 and ≥14 were determined for the DMI-10 and DMI-14, respectively.
Conclusion:
The DMI-18 and DMI-10 are appropriate for use as screening instruments in cardiac patients.
