Background and Purpose:

Depression is reported to be common among cardiac patients (CPs) and is associated with adverse outcome. Therefore AACVPR recently recommended that patients in cardiac rehabilitation (CR) be screened for depression during the intake assessment (Herridge, Stimler, Southard, & King, 2005). The purpose of this clinical poster is to describe our procedures and experience with depression screening.

Methods:

Our phase II CR program enrolls more than 400 new patients annually. More than 50% of referred patients enroll, diminishing the effect of referral bias. First, paients were screened with the Beck Depression Inventory (BDI), a self-report depression screen chosen because of its proven clinical utility, ease of application, scoring and interpretation by diverse health care professionals. A scored above 18 or an affirmative answer to the item concerning suicide prompted immediate physician notification. A score above 12 resulted in an invitation to complete the Structured Clinical Interview for DSM-IV by trained personnel.

Results:

From 4/04-3/05, 386 patients (73% men) were screened. Scores range from 0 to 42, with a median of 5.5. 84 (22%) had scores over 10, which indicates possible depression. 23 (6%) patients had scores over 18 prompting physician notification, and there were no reports of suicidality. 13 patients scoring greater than 12 were interviewed, and 10 (77%) were diagnosed with current depression or depression in partial remission.

Conclusion:

Depression screening is consistent with program goals to improve CPs' psychological functioning. Including a depression screen such as the BDI, followed by a clinical interview or physician notification, can be an efficient way to implement depression screening while requiring relatively few resources. Elevated BDI scores suggesting depression must be verified by treating staff.