The influence of somatic symptoms on Beck Depression Inventory scores in hospitalized postmyocardial infarction patients
The Beck Depression Inventory (BDI) has been used more than any other self-report questionnaire in research on depression in cardiovascular disease. However, no studies have examined whether BDI scores may be influenced by somatic symptoms common after myocardial infarction (MI) that may overlap with symptoms of depression. The objective of this study was to examine whether BDI scores of post-MI patients may be influenced by somatic symptoms that commonly occur after MI, but may not be related to depression.
Post-MI patients and psychiatric outpatients were matched on BDI cognitive-affective symptom scores, sex, and age, and their BDI somatic symptom scores were compared using independent samples t tests.
Somatic symptoms accounted for 57% of BDI total scores for 296 post-MI patients (mean total BDI = 8.8), compared with 50% for 296 matched psychiatric outpatients (mean total BDI = 7.6). Overall, BDI somatic scores of post-MI patients were 1.3 points higher than for psychiatric outpatients (95% CI 0.68 to 1.82; P < 0.001), equivalent to 14% of total scores of post-MI patients.
The relative influence of somatic symptoms on BDI total scores was higher for post-MI patients than for psychiatric outpatients matched on cognitive-affective scores, sex, and age. This finding stands in contrast to that from a previous study that used similar methods and sample comparisons and found that post-MI and psychiatric outpatients did not differ in their endorsement of somatic symptoms on the BDI-II. The BDI-II may be preferable to the BDI in post-MI patients.
Available from: Sherry L Grace
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ABSTRACT: Depressive symptoms following myocardial infarction (MI) are often assessed using self-report questionnaires, such as the Beck Depression Inventory (BDI). No studies have examined whether depressive symptom scores assessed by self-report questionnaires during hospitalization post-MI are influenced by factors related to the acute event or hospitalization compared to subsequent outpatient assessments of the same patients. The objective of this study was to compare BDI total scores, somatic scores, and cognitive/affective scores among post-MI patients in-hospital versus at post-discharge follow-up.
Secondary analysis of data from two existing cohorts of post-MI patients (Groningen, The Netherlands and Toronto, Canada). In-hospital BDI scores and follow-up scores were compared using paired samples t-tests.
There were 1556 patients from the Groningen sample with BDI data in-hospital and at 3-months post-MI and 229 patients from Toronto with data in-hospital and at 6-months post-MI. BDI total, somatic, and cognitive/affective scores did not differ significantly between in-hospital and follow-up assessments in either sample. Similarly, there were no substantive differences in symptom composition in either sample. Somatic symptoms accounted for 66.3% of total BDI scores in-hospital versus 64.9% at 3-months post-MI for Groningen patients and for 62.1% of total scores in-hospital versus 64.3% at 6-months post-MI for Toronto patients.
Overall BDI total scores, somatic scores, and cognitive/affective scores did not differ between in-hospital and subsequent outpatient assessments. The timing of when depressive symptoms are assessed post-MI does not appear to influence the overall level of BDI scores or the composition of symptoms that are reported.
Available from: Tam Truong Donnelly
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ABSTRACT: Cardiovascular disease (CVD) is increasing in Middle Eastern countries. Depression is associated with increased morbidity and mortality rates among cardiovascular (CV) patients. Early detection of and intervention for depression among CV patients can reduce morbidity and mortality and save health care costs. Public information on mental health care needs of Arab CV patients living in Middle East regions is scattered and limited. This literature review surveyed and summarized research studies to learn what is known about the relationship between depression and CVD in Middle Eastern populations. The information will raise awareness among health care professionals and policy makers regarding the clinical significance of depression in Arab CV patients. It might contribute to development of culturally appropriate and effective mental health care services. Multiple databases were searched and 60 articles were assessed, including studies that investigated depression in Arab CV patient populations, physiological mechanisms of depression-CVD comorbidity, and intervention strategies that affect CV risk in depressed Arab patients. We discuss the extent to which this issue has been explored in Arab populations living in Middle East regions and Arab populations living abroad. We recommend that more comprehensive and in-depth research studies be conducted with Arab cardiac patients to enable implementation of culturally appropriate and effective mental health care interventions.
Available from: Rejane Kiyomi Furuya
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ABSTRACT: this study investigated the association of somatic and cognitive-affective symptoms with sex and age, among patients hospitalized with heart disease.
this study was a secondary analysis of two previous observational studies totaling 531 patients with heart disease, hospitalized from 2005 to 2011 in two public hospitals in Ribeirão Preto, state of São Paulo, Brazil. Somatic and cognitive-affective symptoms were assessed using the subscales of the Beck Depression Inventory - I (BDI-I).
of 531 participants, 62.7% were male, with a mean age 57.3 years (SD= 13.0) for males and 56.2 years (SD= 12.1) for females. Analyses of variance showed an effect of sex (p<0.001 for somatic and p=0.005 for cognitive-affective symptoms), but no effect of age. Women presented with higher mean values than men in both BDI-I subscales: 7.1 (4.5) vs. 5.4 (4.3) for somatic, and 8.3 (7.9) vs. 6.7 (7.2) for cognitive-affective symptoms. There were no differences by age for somatic (p=0.84) or cognitive-affective symptoms (p=0.84).
women hospitalized with heart disease had more somatic and cognitive-affective symptoms than men. We found no association of somatic and cognitive-affective symptoms with age. Future research for these patients could reveal whether these differences according to sex continue throughout the rehabilitation process.
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