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Cited by 56Cardiac Health and Mental HealthHeart Failure Treatment and ManagementMental Health Treatment and Access

A Positive 2-Item Patient Health Questionnaire Depression Screen Among Hospitalized Heart Failure Patients is Associated With Elevated 12-Month Mortality

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Rollman, Bruce L., Herbeck Belnap, Bea, Mazumdar, Sati, Houck, Patricia R., He, Fanyin, Alvarez, Rene J., Schulberg, Herbert C., Reynolds, Charles F. +1 more·2012·Journal of Cardiac Failure
DOI 10.1016/j.cardfail.2011.11.002PMC PMC3298032
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Abstract

Background Given the association of depression with poorer cardiac outcomes, an American Heart Association Science Advisory has advocated routine screening of cardiac patients for depression using the 2-item Patient Health Questionnaire (PHQ-2) "at a minimum." However, the prognostic value of the PHQ-2 among HF patients is unknown. Methods and results We screened hospitalized HF patients (ejection fraction [EF] <40%) that staff suspected may be depressed with the PHQ-2, and then determined vital status at up to 12-months follow-up. At baseline, PHQ-2 depression screen-positive patients (PHQ-2+; n = 371), compared with PHQ-2 screen-negative patients (PHQ-2-; n = 100), were younger (65 vs 70 years) and more likely to report New York Heart Association (NYHA) functional class III/IV than class II symptoms (67% vs. 39%) and lower levels of physical and mental health-related quality of life (all P ≤ .002); they were similar in other characteristics (65% male, 26% mean EF). At 12 months, 20% of PHQ-2+ versus 8% of PHQ-2- patients had died (P = .007) and PHQ-2 status remained associated with both all-cause (hazard ratio [HR] 3.1, 95% confidence interval [CI] 1.4-6.7; P = .003) and cardiovascular (HR 2.7, 95% CI 1.1-6.6; P = .03) mortality even after adjustment for age, gender, EF, NYHA functional class, and a variety of other covariates. Conclusions Among hospitalized HF patients, a positive PHQ-2 depression screen is associated with an elevated 12-month mortality risk.

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  • Brief, well-validated 2-item screening tools have previously been used to screen for mood and anxiety symptoms in a range of clinical cardiology settings.

    “These screening tools have previously been used to screen for mood and anxiety symptoms in a range of clinical cardiology settings. 226-228”

    From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [227]

    The Introduction and Methods (page numbers unavailable) describe use of the validated two-item PHQ-2 to screen for depression in hospitalized heart-failure patients, and discuss its use in coronary heart disease patients. The Methods assess anxiety with a separate PRIME-MD Anxiety Module, not a two-item tool; this paper therefore does not support the claim that a two-item tool screened for both mood and anxiety symptoms across a range of cardiology settings. (LLM, conf=0.86)

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  1. [42]Barefoot JC Helms MJ Mark DB Blumenthal JA Califf RM Haney TL Depression and long-term mortality risk in patients with coronary artery disease Am J Card 1996 78 613 617 8831391

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Authors
Rollman, B. L., Herbeck Belnap, B., Mazumdar, S., Houck, P. R., He, F., Alvarez, R. J., Schulberg, H. C., Reynolds, C. F., & McNamara, D. M.
Affiliations
  • University of Pittsburgh (US)
  • Weill Cornell Medicine (US)
ORCID
Venue
Journal of Cardiac Failure
Publisher
Elsevier BV
Published
2012-03
Volume
18
Issue
3
Pages
238-245
ISSN
1071-9164 (ISSN-L)
DOI
10.1016/j.cardfail.2011.11.002
PMC
PMC3298032
OpenAlex
W2073207113
Cited by
56
References
60
Citations by year
2026: 3 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 5 · 2020: 6 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 8 · 2015: 7 · 2014: 3 · 2013: 5 · 2012: 3
FWCI
2.42
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Cardiac Failure (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (UL1TR000005)
  • National Institute of Mental Health (R34MH078030)
  • National Center for Research Resources (UL1RR024153)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
depression screening, PHQ-2, heart failure, depression, mortality, prognostic value, hospitalized patients, all-cause mortality, cardiovascular mortality, quality of life, NYHA functional class
MeSH terms
Adult, Aged, Aged, 80 and over, Depression, Female, Follow-Up Studies, Heart Failure, Hospitalization, Humans, Male, Mass Screening, Middle Aged, Surveys and Questionnaires, Time Factors, Survival Rate, Young Adult

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