Depression screening after cardiac surgery: A six month longitudinal follow up for cardiac events, hospital readmissions, quality of life and mental health

Phillip J Tully; Harald Baumeister; Jayme S Bennetts; Greg D Rice; Robert A Baker

doi:10.1016/j.ijcard.2016.01.015

Depression screening after cardiac surgery: A six month longitudinal follow up for cardiac events, hospital readmissions, quality of life and mental health

Int J Cardiol. 2016 Mar 1:206:44-50. doi: 10.1016/j.ijcard.2016.01.015. Epub 2016 Jan 7.

Authors

Phillip J Tully¹, Harald Baumeister², Jayme S Bennetts³, Greg D Rice³, Robert A Baker⁴

Affiliations

¹ Cardiac Surgery Research, Department of Surgery, Flinders Medical Centre and Flinders University of South, Australia; INSERM U897 Equipe de Neuro-épidémiologie, Université de Bordeaux, France; Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany; Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide, Australia.
² Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany; Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Germany.
³ Cardiac Surgery Research, Department of Surgery, Flinders Medical Centre and Flinders University of South, Australia.
⁴ Cardiac Surgery Research, Department of Surgery, Flinders Medical Centre and Flinders University of South, Australia. Electronic address: Rob.Baker@health.sa.gov.au.

PMID: 26774829
DOI: 10.1016/j.ijcard.2016.01.015

Abstract

Objectives: To report the 6-month longitudinal outcomes of routine depression screening in cardiac patients.

Methods: Routine depression screening consisted of the Patient Health Questionnaire (PHQ) administered 30-days after cardiac surgery at the Flinders Medical Centre, South Australia. Complete data was obtained on 481 patients who were subdivided into three groups; depressed-cardiac control determined by current anti-depressant use or history of depression in medical records (n=90), depression screen-positives (PHQ≥10, n=46) and depression screen-negatives (PHQ≤9, n=345). These groups were re-assessed at 6 month follow-up for major adverse cardiac events (MACE), hospital readmission, quality of life (SF-12), symptomatic depression, and use of antidepressants, anxiolytics and psychotherapy.

Results: By six-month follow-up the depression screen-positive group was at a higher risk of MACE (adjusted odds ratio [OR] 2.16; 95% confidence interval [CI] .98-4.74). The depression screen-positive group was also at a higher risk of depressed mood (PHQ scores ≥10: adjusted OR 6.54; 95% CI 3.16-13.53). The depression screen-positive group also reported significantly poorer QOL in five domains (all p<.001 with Bonferroni correction). The depression screen-positive group was more likely to be initiated on antidepressant and anxiolytic (ORs 5.89 and 4.74 respectively) at follow-up. The number needed to screen to achieve one additional depression remission case was 9 in the screen-positive group (versus the depression-control group).

Conclusion: Depression screening was associated with an increase in psychotropic medication use however depression, morbidity and quality of life remained poor at six months.

Keywords: Cardiac surgery; Coronary heart disease; Depression; Diagnosis; Health care; Quality assurance.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Anti-Anxiety Agents / therapeutic use
Antidepressive Agents / therapeutic use
Cardiac Surgical Procedures / adverse effects*
Cardiac Surgical Procedures / psychology*
Depression / diagnosis*
Depression / drug therapy
Depression / etiology
Early Diagnosis
Female
Follow-Up Studies
Heart Diseases / psychology
Heart Diseases / surgery*
Humans
Longitudinal Studies
Male
Patient Readmission / statistics & numerical data
Quality of Life

Substances

Anti-Anxiety Agents
Antidepressive Agents