scholarly journals Assessing Depression in Cardiac Patients: What Measures Should Be Considered?

2014 ◽  
Vol 2014 ◽  
pp. 1-17 ◽  
Author(s):  
M. Ceccarini ◽  
G. M. Manzoni ◽  
G. Castelnuovo
Keyword(s):  
Rating Scale ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Cardiac Patients ◽  
Cardiac Events ◽  
Premature Deaths ◽  
Cardiac Symptoms ◽  
Hospitalised Patients

It is highly recommended to promptly assess depression in heart disease patients as it represents a crucial risk factor which may result in premature deaths following acute cardiac events and a more severe psychopathology, even in cases of subsequent nonfatal cardiac events. Patients and professionals often underestimate or misjudge depressive symptomatology as cardiac symptoms; hence, quick, reliable, and early mood changes assessments are warranted. Failing to detect depressive signals may have detrimental effects on these patients’ wellbeing and full recovery. Choosing gold-standard depression investigations in cardiac patients that fit a hospitalised cardiac setting well is fundamental. This paper will examine eight well established tools following Italian and international guidelines on mood disorders diagnosis in cardiac patients: the Hospital Anxiety and Depression Scale (HADS), the Cognitive Behavioural Assessment Hospital Form (CBA-H), the Beck Depression Inventory (BDI), the two and nine-item Patient Health Questionnaire (PHQ-2, PHQ-9), the Depression Interview and Structured Hamilton (DISH), the Hamilton Rating Scale for Depression (HAM-D/HRSD), and the Composite International Diagnostic Interview (CIDI). Though their strengths and weaknesses may appear to be homogeneous, the BDI-II and the PHQ are more efficient towards an early depression assessment within cardiac hospitalised patients.

Screening for Depression in the Medically Ill: The Suggested Utility of a Cognitive-Based Approach

2001 ◽  
Vol 35 (4) ◽  
pp. 474-480 ◽  
Author(s):  
Gordon Parker ◽  
Gordon Parker ◽  
Therese Hilton ◽  
Dusan Hadzi-Pavlovic ◽  
Jatinder Bains
Keyword(s):  
Mood State ◽  
Depression Scale ◽  
Composite International Diagnostic Interview ◽  
Depressive Mood ◽  
Physical Symptoms ◽  
Diagnostic Interview ◽  
Medical Illness ◽  
Medically Ill ◽  
High Internal Consistency ◽  
Comparison Measures

Objective: There is a need for a valid measure of depression in the medically ill, and one that is independent of medical illness characteristics. As yet, there is no such widely accepted measure. We thus report on the early development of such a measure using cognitive constructs that define depressive mood state nuances. Method: We studied 67 patients with a significant medical illness, verbally administering a set of 81 provisional items. Sample members also alternatively completed one of two comparison measures: the Hospital Anxiety and Depression Scale (HADS) or the Beck Depression Inventory for Primary Care (BDI-PC). A psychiatrist interviewed a subset to determine severity of any depression and whether subjects met formalized caseness criteria for depression. The Composite International Diagnostic Interview (CIDI) was also administered during interviews to assess agreement with psychiatrist judgements about caseness. Results: A 16-item measure with high internal consistency was derived, with validation analyses suggesting it was distinctly superior to the HADS and somewhat superior to the BDI-PC measure. Conclusions: A cognitive-based approach (as used by both our measure and the BDI-PC) to screen for depression in medically ill groups appears to have distinct utility in identifying depressed patients, and in avoiding confounding influences of physical symptoms.

scholarly journals Presence of individual (residual) symptoms during depressive episodes and periods of remission: a 3-year prospective study

2010 ◽  
Vol 41 (6) ◽  
pp. 1165-1174 ◽  
Author(s):  
H. J. Conradi ◽  
J. Ormel ◽  
P. de Jonge
Keyword(s):  
Prospective Study ◽  
Depressive Symptomatology ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Residual Symptoms ◽  
Full Remission ◽  
Sleeping Problems ◽  
The Individual ◽  
Major Depressive Episodes ◽  
Depressive Episodes

BackgroundResidual depressive symptomatology constitutes a substantial risk for relapse in depression. Treatment until full remission is achieved is therefore implicated. However, there is a lack of knowledge about the prevalence of (1) residual symptoms in general and (2) the individual residual symptoms in particular.MethodIn a 3-year prospective study of 267 initially depressed primary care patients we established per week the presence/absence of the individual DSM-IV depressive symptoms during subsequent major depressive episodes (MDEs) and episodes of (partial) remission. This was accomplished by means of 12 assessments at 3-monthly intervals with the Composite International Diagnostic Interview (CIDI).ResultsIn general, residual depressive symptomatology was substantial, with on average two symptoms present during remissions. Three individual symptoms (cognitive problems, lack of energy and sleeping problems) dominated the course of depression and were present 85–94% of the time during depressive episodes and 39–44% of the time during remissions.ConclusionsResidual symptoms are prevalent, with some symptoms being present for almost half of the time during periods of remission. Treatment until full remission is achieved is not common practice, yet there is a clear need to do so to prevent relapse. Several treatment suggestions are made.

Depressive Mixed States: Symptomatology, Prevalence and Principles of Treatment

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
W. Drozdz ◽  
A. Borkowska
Keyword(s):  
Affective Disorders ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Assessment Tools ◽  
The Other ◽  
Mood Stabilizers ◽  
Hamilton Depression Scale ◽  
Principles Of Treatment ◽  
Bipolar Patients

Current diagnostic systems (DSM-IV-TR and ICD-10) do not include depressive mixed state (DMS) as a separate category. However, both historical descriptions and data from recent research clearly indicate that cooccurrence of (hypo)maniacal and depressive symptoms is standard in clinical picture of affective disorders. Most frequently employed criterion for DMS is the presence of at least three symptoms of (hypo)mania for 7 days during a major depressive episode. Not only formal diagnostic criteria for DMS are lacking but also psychometric assessment tools (for example the Hamilton Depression Scale or the MADRS) were designed around the features of “classical” depression. The other obstacles to recognize DMS could be lack of insight into the (hypo)maniacal symptoms in patients and cognitive dysfunctions present during an episode. On the other hand, newly created instrument, the Bipolar Depression Rating Scale, may assist clinical evaluation of DMS. Despite predominating depressive symptomatology, the principles of treatment of DMS suggest avoidance of antidepressant monotherapy in favor of mood stabilizers' administration. Actually DMS may emerge as a complication of antidepressant monotherapy in some bipolar patients or may be induced with interferon-alpha treatment in some chronic hepatitis C patients. Important consequences of both spontaneous and drug-induced DMS could be the roughening of affective symptomatology, resistance to antidepressants and the increase of suicidality. Thorough appraisal of symptoms seen in patients with affective disorders for indicators of DMS could have critical consequences for functional outcomes.

scholarly journals Shades of Blue and Gray: A Comparison of the Center for Epidemiologic Studies Depression Scale and the Composite International Diagnostic Interview for Assessment of Depression Syndrome in Later Life

2019 ◽  
Vol 60 (4) ◽  
pp. e242-e253 ◽  
Author(s):  
Linh Dang ◽  
Liming Dong ◽  
Briana Mezuk
Keyword(s):  
Short Form ◽  
Depression Scale ◽  
Composite International Diagnostic Interview ◽  
Later Life ◽  
Epidemiologic Studies ◽  
Diagnostic Interview ◽  
Psychiatric Research ◽  
And Gender ◽  
Ethnicity And Gender ◽  
Design And Methods

Abstract Background and Objectives Psychiatric research lacks the equivalent of a thermometer, that is, a tool that accurately measures mental disorder regardless of context. Instead, the psychometric properties of scales that purport to assess psychopathology must be continuously evaluated. To that end, this study evaluated the diagnostic agreement between the eight-item Center for Epidemiologic Studies Depression Scale (CESD-8) and the Composite International Diagnostic Interview—short form (CIDI-SF) in the Health and Retirement Study (HRS). Research Design and Methods Data come from 17,613 respondents aged >50 from the 2014 wave of the HRS. Kappa coefficients were used to assess the agreement between the 2 instruments on depression classification across a range of thresholds for identifying case status, including variation across subgroups defined by age, race/ethnicity, and gender. Results The point prevalence of depression syndrome estimated by the CESD was higher than that estimated by the CIDI-SF (CESD: 9.9%–19.5% depending on the cutoff applied to the CESD vs CIDI-SF: 7.7%). Assuming CIDI-SF as the gold standard, the CESD yielded a sensitivity of 56.2%–70.2% and specificity of 84.7%–94.0% across the range of cutoffs. The agreement on depression classification was weak (κ = 0.32–0.44). Discussion and Implications Depression cases identified by the CESD have poor agreement with those identified by the CIDI-SF. Conceptually, psychological distress as measured by the CESD is not interchangeable with depression syndrome as measured by the CIDI-SF. Population estimates of depression among older adults based on the CESD should be interpreted with caution.

scholarly journals Prevalence of depression in people living with HIV and AIDS at the Kalafong Provincial Tertiary Hospital Antiretroviral Clinic

2019 ◽  
Vol 25 ◽  
Author(s):  
Brett Van Coppenhagen ◽  
Helene S. Duvenage
Keyword(s):  
Rating Scale ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Hiv And Aids ◽  
Cd4 Count ◽  
Definitive Treatment ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Prevalence Of Depression ◽  
Living With Hiv

Background: Compared to the general population, there is an increased prevalence of depression in people living with HIV and AIDS (PLWHA). The combination of these two common illnesses has profound consequences on the patient and on the healthcare system.Objective: This study determined the prevalence of depressive symptomatology in PLWHA attending the Kalafong Hospital ARV Clinic. The study also established if the patients received definitive treatment for unipolar depression.Methods: A cross-sectional, descriptive study was carried out on 622 adult patients, aged 18 years or older. A brief rating scale for depression, the Centre for Epidemiological Study Depression Scale (CES-D) was administered to participants. The CES-D is a 20-item self-rating scale that assesses current levels of depression as per DSM-IV criteria. The traditional score of 16 and above was used to define a case of depression.Results: The prevalence of depression according to CES-D scale was 53.8%. The study found that none of the 622 patients ever received definitive treatment for depression. A lower CD4 count is associated with more depressive symptomatology, most significantly in patients with a CD4 count of 50 or less.Conclusions: Depressive symptomatology was highly prevalent in the study patients. Despite the high prevalence, none of the study sample patients were treated for clinical depression. The findings reflect the importance of evaluating for depression in PLWHA, especially in high-risk groups such as patients presenting for their initiation visit or patients with a CD4 count of 50 or less. Depression remains under-recognised and under-treated in PLWHA.

Erkennungsgüte dreier deutschsprachiger Screeninginstrumente für Depression bei hospitalisierten Patienten mit koronarer Herzerkrankung

2017 ◽  
Vol 46 (01) ◽  
pp. 41-48 ◽  
Author(s):  
Mira Tschorn ◽  
Nina Rieckmann ◽  
Volker Arolt ◽  
Katja Beer ◽  
Wilhelm Haverkamp ◽  
...  
Keyword(s):  
Depression Scale ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Patient Health Questionnaire ◽  
Anxiety And Depression ◽  
Depressive Störungen ◽  
Health Questionnaire ◽  
Hospital Anxiety ◽  
Patient Health

Zusammenfassung Ziel Vergleich der Erkennungsgüte von drei Depressions-Screeninginstrumenten bei Patienten mit koronarer Herzerkrankung (KHK). Methodik 1019 KHK-Patienten erhielten den Patient Health Questionnaire (PHQ-9 und PHQ-2) und die Hospital Anxiety and Depression Scale (HADS-D) sowie ein klinisches Interview (Composite International Diagnostic Interview) als Referenzstandard. Ergebnisse Bezüglich der Erkennungsgüte waren PHQ-9 und HADS-D dem PHQ-2 überlegen. Optimale Cut-off-Werte waren 7 (PHQ-9 und HADS-D) und 2 (PHQ-2). Schlussfolgerung PHQ-9 und HADS-D haben eine vergleichbare Diskriminationsfähigkeit für depressive Störungen bei KHK-Patienten.

scholarly journals Psychiatric history and subthreshold symptoms as predictors of the occurrence of depressive or anxiety disorder within 2 years

2011 ◽  
Vol 198 (3) ◽  
pp. 206-212 ◽  
Author(s):  
Julie Karsten ◽  
Catharina A. Hartman ◽  
Johannes H. Smit ◽  
Frans G. Zitman ◽  
Aartjan T. F. Beekman ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Depressive Disorder ◽  
Anxiety Disorders ◽  
Depressive Disorders ◽  
Depressive Symptomatology ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Self Report ◽  
History Of ◽  
History Of Depression

BackgroundPast episodes of depressive or anxiety disorders and subthreshold symptoms have both been reported to predict the occurrence of depressive or anxiety disorders. It is unclear to what extent the two factors interact or predict these disorders independently.AimsTo examine the extent to which history, subthreshold symptoms and their combination predict the occurrence of depressive (major depressive disorder, dysthymia) or anxiety disorders (social phobia, panic disorder, agoraphobia, generalised anxiety disorder) over a 2-year period.MethodThis was a prospective cohort study with 1167 participants: the Netherlands Study of Depression and Anxiety. Anxiety and depressive disorders were determined with the Composite International Diagnostic Interview, subthreshold symptoms were determined with the Inventory of Depressive Symptomatology–Self Report and the Beck Anxiety Inventory.ResultsOccurrence of depressive disorder was best predicted by a combination of a history of depression and subthreshold symptoms, followed by either one alone. Occurrence of anxiety disorder was best predicted by both a combination of a history of anxiety disorder and subthreshold symptoms and a combination of a history of depression and subthreshold symptoms, followed by any subthreshold symptoms or a history of any disorder alone.ConclusionsA history and subthreshold symptoms independently predicted the subsequent occurrence of depressive or anxiety disorder. Together these two characteristics provide reasonable discriminative value. Whereas anxiety predicted the occurrence of an anxiety disorder only, depression predicted the occurrence of both depressive and anxiety disorders.

Depression in Elderly Persons and its Correlates in Family Practice: A Canadian Study

1992 ◽  
Vol 70 (2) ◽  
pp. 359-368 ◽  
Author(s):  
Patricia Stephenson-Cino ◽  
Meir Steiner ◽  
Lester Krames ◽  
Ellen Bouchard Ryan ◽  
Gail Huxley
Keyword(s):  
Depressive Symptomatology ◽  
Community Sample ◽  
Program Planning ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Diagnostic Interview ◽  
Elderly Persons ◽  
Never Married ◽  
Gender And Education ◽  
Relationship Of

Depression was studied in a Canadian community sample of 582 men and 906 women over the age of 65 years. The Center for Epidemiological Studies Depression Scale (CES-D) provided the measure of depressive symptomatology. The Diagnostic Interview Schedule was used to confirm clinical diagnosis. A total of 8% of the sample (4.3% of men and 10.4% of women) were at or above the cut-off point of 16 on the Depression Scale. Significant Pearson correlations with depression were found for gender and education. The married and never married persons showed low depression while the widowed, separated, or divorced appeared to be at high risk. The relationship of marital status to depression is primarily a woman's issue as most elderly men are married. This finding may have implications for policy and program planning for this population.

Responsiveness of observer rating scales by analysis of number of days until improvement in patients with major depression

1998 ◽  
Vol 13 (3) ◽  
pp. 143-145 ◽  
Author(s):  
N Lauge ◽  
K Behnke ◽  
J Søgaard ◽  
B Bahr ◽  
P Bech
Keyword(s):  
Major Depression ◽  
Rating Scales ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Response To Treatment ◽  
Hamilton Depression Scale ◽  
Scale Scores ◽  
Pre Treatment ◽  
Treatment Onset

SummarySeveral well-known observer scales, including the Hamilton Depression Scale (HAM-D), Montgomery-Åsberg Scale (MADRS), Major Depression Rating Scale (MDS), Melancholia Scale (MES), and Inventory for Depressive Symptomatology (IDS) used for measuring severity of depressive states have been compared by their responsiveness in an open trial including patients treated with a combination of citalopram and mianserin. The patients fulfilled the Diagnostic and Statistical Manual (DSM)-IV criteria for major depressive episode, and all scored 18 or more on the HAM-D before treatment. Onset of antidepressant action was defined as an improvement of rating scale scores of 25% or more of pre-treatment scores. A response to treatment was defined as a reduction of 50% or more on the pre-treatment scores. The results showed that the number of treatment days until improvement was 11 to 13 with no difference between the scales. The days until response were between 18 and 21 with no difference between the scales. In conclusion, the depression scales were found to be equal in their ability to detect changes in depressive symptoms during treatment. The mean of days to response was 19 for the combination of citalopram and mianserin. This is similar to the response for the combination of fluoxetine and pinolol.

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