Feasibility and Utility of Screening for Depression and Anxiety Disorders in Patients With Cardiovascular Disease
Feasibility and Utility of Screening for Depression and Anxiety Disorders in Patients With Cardiovascular Disease
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DOI：
10.1161/circoutcomes.111.000049
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发表时间：
2013-07-01
影响因子：
6.9
通讯作者：
Huffman, Jeff C.
中科院分区：
文献类型：
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作者：
Celano, Christopher M.;Suarez, Laura;Huffman, Jeff C.
研究背景心脏病患者的抑郁和焦虑是常见的，与发病率和死亡率独立相关。我们的目的是探索使用3步法来识别患有抑郁症、广泛性焦虑症（GAD）或惊恐障碍的心脏病住院患者;了解个体筛选项目在识别这些疾病中的预测价值;方法和结果识别心脏病住院患者的抑郁和焦虑障碍作为护理管理的一部分，试验中，使用迭代的3步筛选程序。这包括护理数据集中现有的4项（应对筛查）工具，积极应对筛查患者的5项筛查（患者健康问卷-2（PHQ-2）、GAD-2和关于恐慌发作的项目），以及使用PHQ-9和精神障碍焦虑障碍模块的初级保健评估的诊断评估。总体而言，6210名住院患者接受了应对筛查，581名完成了所有3个评估步骤的部分，210名接受了诊断（143名抑郁症，129名GAD，30名惊恐障碍）。控制年龄、性别和其他筛查项目后，PHQ-2项目独立预测抑郁症（兴趣少/快乐：比值比[OR]=6.65，P
BackgroundDepression and anxiety in patients with cardiac disease are common and independently associated with morbidity and mortality. We aimed to explore the use of a 3-step approach to identify inpatients with cardiac disease with depression, generalized anxiety disorder (GAD), or panic disorder; understand the predictive value of individual screening items in identifying these disorders; and assess the relative prevalence of these disorders in this cohort.Methods and ResultsTo identify depression and anxiety disorders in inpatients with cardiac disease as part of a care management trial, an iterative 3-step screening procedure was used. This included an existing 4-item (Coping Screen) tool in nursing data sets, a 5-item screen for positive Coping Screen patients (Patient Health Questionnaire-2 [PHQ-2], GAD-2, and an item about panic attacks), and a diagnostic evaluation using PHQ-9 and the Primary Care Evaluation of Mental Disorders anxiety disorder modules. Overall, 6210 inpatients received the Coping Screen, 581 completed portions of all 3 evaluation steps, and 210 received a diagnosis (143 depression, 129 GAD, 30 panic disorder). Controlling for age, sex, and the other screening items, PHQ-2 items independently predicted depression (little interest/pleasure: odds ratio [OR]=6.65, P