Rationale:

Population with chronic condition exhibits a high prevalence of depression. Exercise training show a major impact in improving various forms of depression. Several tools were developed for depression evaluation such as questionnaires.

Objective:

The aim of this work was to specify the most sensitive depression scale for cardiopulmonary rehabilitation.

Methodology:

74 cardiopulmonary patients followed a four-week exercise training program in a cardiac rehabilitation center. Depression was assessed using the Beck Depression Inventory (Beck), the Geriatric Depression Scale (GDS), the Center for Epidemiologic Studies Depression scale (CES-D) and the Hospital Anxiety and Depression scale (HAD). The patients filled out the 4 questionnaires and underwent an incremental exercise test before and after training. We dichotomized the groups by physical capacity level and physical improvement.

Results:

All the depression tests showed an improvement of the score after exercise training whatever the type of pathology, deconditioning or improvement after exercise training. The results were significant for the Beck, CES-D and HAD for all situations. The GDS was significant only in 1 situation for pulmonary patients. When we dichotomized for the deconditioning, the Beck (P =.0007 vs P =,0637) and the HAD (P =,0337 vs P =,0034) showed inverse impact of the deconditioning on the depression after exercise training. When we dichotomized for physical improvement, the Beck was the most sensitive (P <.0001) for the patients who had the less exercise capacity improvement as compared to patients with larger improvement (P =.0637). The CES-D seems the most sensitive depression questionnaire for cardiopulmonary rehabilitation use.

Conclusion:

Conflicting results were found depending on the questionnaire. The improvements evaluated with one or another questionnaire is extremely variable, and pathology, physical capacity or improvement had a major impact on the results. Tools such as questionnaire used to evaluate depression modifications can not replace a clinician like a psychologist in an individual health evaluation.