Rationale: The AACVPR recommends screening for depression in cardiac rehabilitation (CR) using a valid and reliable measure. However, many assessments are performed at intake to CR. Although depression measures such as the Beck Depression Inventory (BDI) are widely used in CR, a brief screener may increase efficiency and reduce patient burden. We examined whether 3 items assessing depression would accurately identify cases of probable depression (BDI 15 or greater).

Method: Three depression screening items (depression for 2 weeks during the past year, depression for the past 2 years, and depression during the past year) and the 21-item BDI were administered to 587 patients at intake in a phase II CR program.

Results: Participants were 70% men averaging 66 years of age (range = 28-89). Thirty-one percent endorsed at least 1 of the 3 screening items and 7% endorsed all 3 items; 10.9% had a BDI score of 15 or above. The 3 screening items had high internal reliability (Cronbach alpha = .736), high specificity (74.8%), and high sensitivity (79.7%), and yielded only 2.2% false negatives. Patients who endorsed at least 1 of the 3 depression screening items were 11 times more likely to have a BDI score of 15 or above compared to patients who endorsed none of the three items.

Conclusion: The results suggest that a sequential screening process in which patients are required to take the BDI only after acknowledging 1 or more of the 3 screening items would be an efficient and accurate approach to depression screening in CR. With the large amount of patient data gathered during the intake process, the use of the 3-item screen would allow CR staff to quickly screen for depression without sacrificing any clinically relevant data. Demonstrating that the BDI accurately predicts depression as assessed by a diagnostic interview would provide further support for adopting a sequential screening process in CR.