Feasibility and Utility of Screening for Depression and Anxiety Disorders in Patients With Cardiovascular Disease
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Background—: Depression and anxiety in patients with cardiac disease are common and independently associated with morbidity and mortality. We aimed to explore the use of a 3-step approach to identify inpatients with cardiac disease with depression, generalized anxiety disorder (GAD), or panic disorder; understand the predictive value of individual screening items in identifying these disorders; and assess the relative prevalence of these disorders in this cohort. Methods and Results—: To identify depression and anxiety disorders in inpatients with cardiac disease as part of a care management trial, an iterative 3-step screening procedure was used. This included an existing 4-item (Coping Screen) tool in nursing data sets, a 5-item screen for positive Coping Screen patients (Patient Health Questionnaire-2 [PHQ-2], GAD-2, and an item about panic attacks), and a diagnostic evaluation using PHQ-9 and the Primary Care Evaluation of Mental Disorders anxiety disorder modules. Overall, 6210 inpatients received the Coping Screen, 581 completed portions of all 3 evaluation steps, and 210 received a diagnosis (143 depression, 129 GAD, 30 panic disorder). Controlling for age, sex, and the other screening items, PHQ-2 items independently predicted depression (little interest/pleasure: odds ratio [OR]=6.65, P <0.001; depression: OR=5.24, P =0.001), GAD-2 items predicted GAD (anxious: OR=4.09, P =0.003; unable to control worrying: OR=10.46, P <0.001), and the panic item predicted panic disorder (OR=49.61, P <0.001). Conclusions—: GAD was nearly as prevalent as depression in this cohort, and GAD-2 was an effective screening tool; however, panic disorder was rare. These results support the use of 2-step screening for depression and GAD beginning with a 4-item scale (GAD-2 plus PHQ-2). Clinical Trial Registration—: Unique Identifier: NCT01201967. URL: http://www.clinicaltrials.gov/ct2/show/NCT01201967 .
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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 [228]
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- Authors
- Celano, C. M., Suarez, L., Mastromauro, C., Januzzi, J. L., & Huffman, J. C.
- Affiliations
- Harvard University (US)
- Venue
- Circulation: Cardiovascular Quality and Outcomes
- Published
- 2013-07
- Volume
- 6
- Issue
- 4
- Pages
- 498-504
- ISSN
- 1941-7705 (ISSN-L)
- 1941-7713
- OpenAlex
- W2104056193
- Cited by
- 67
- References
- 33
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 10 · 2020: 3 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 7 · 2015: 6 · 2014: 5
- FWCI
- 4.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Cardiovascular Quality and Outcomes (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression screening, anxiety disorders, generalized anxiety disorder, panic disorder, cardiovascular disease, cardiac inpatients, PHQ-2, GAD-2, screening instrument validity, depression prevalence
- MeSH terms
- Adaptation, Psychological, Aged, Aged, 80 and over, Anxiety Disorders, Boston, Depression, Feasibility Studies, Female, Heart Diseases, Humans, Inpatients, Male, Middle Aged, Predictive Value of Tests, Psychiatric Status Rating Scales, Surveys and Questionnaires, Risk Factors, Prevalence, Multivariate Analysis, Chi-Square Distribution, Logistic Models, Odds Ratio, Single-Blind Method, Panic Disorder
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