Behavior Modification

 

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Behavior Modification, Vol. 27, No. 1, 26-36 (2003)
DOI: 10.1177/0145445502238691

Assessing Depression in the Cardiac Patient

When Is the Appropriate Time to Assess Depression in the Patient Undergoing Coronary Revascularization?

Walker S. Carlos Poston

C. Keith Haddock

Mark W. Conard

Phillip Jones

John Spertus

Mid America Heart Institute and University of Missouri–Kansas City

Depression is a well-established risk factor for cardiovascular disease related morbidity and mortality. It is common to screen for depression in patients undergoing coronary revascularization prior to revascularization; however, the validity of this assessment is unclear as some patients may experience transient, reactive depression rather than persistent depression. The authors evaluated whether an initial or 1-month postprocedure screen was optimal for identifying consistently depressed patients. Depression at 1-month postprocedure was a stronger predictor of depression at months 2 to 6 than baseline depression. After adjusting potential confounding variables, there was a much stronger relationship between 1-month and 6-month depression status (OR = 28.7 if depressed at 1 month, p < .001) than between baseline and 6 month depression status (OR = 6.5 if depressed at baseline, p < .001). Screening for depression at the time of revascularization is not as predictive of depression at 6 months as it is 1 month postprocedure.

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