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Depression Screening in Cardiac Surgery Patients
Malin Stenman1, Ulrik Sartipy2
1Perioperative Medicine and Intensive Care Function, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Insights
Depression screening in cardiac surgery patients using the Patient Health Questionnaire (PHQ-9) is feasible. While elective patients had good response rates, urgent patients require improved screening methods.
Area of Science:
- Cardiology
- Psychiatry
- Health Services Research
Background:
- Depression is prevalent in patients with ischemic heart disease.
- Preoperative depression is a risk factor for outcomes after coronary artery bypass grafting.
- The American Heart Association recommends depression screening for heart disease patients.
Purpose of the Study:
- To assess the feasibility of a depression screening program in cardiac surgery patients.
- To evaluate the results of this screening initiative.
- To identify the prevalence of depression in this patient population.
Main Methods:
- A depression screening project using the Patient Health Questionnaire (PHQ-9) was implemented at a cardiac surgery department.
- Patients undergoing elective surgery received the PHQ-9 by mail; urgent patients received it on the ward.
- Data collected included baseline characteristics, medical history, medications, and PHQ-9 scores.
Main Results:
- Out of 2,512 cardiac surgery patients, 1,133 (45%) completed the PHQ-9.
- Response rates were 64% for elective surgery patients and 15% for urgent patients.
- Fifteen percent of patients scored ≥10 on the PHQ-9, indicating major depression, with women showing higher prevalence (23% vs. 12% in men).
Conclusions:
- Systematic depression screening with PHQ-9 in cardiac surgery patients is feasible and resource-efficient.
- Response rates were satisfactory for elective patients, but improvements are needed for urgent patients.
- Further research should explore the benefits of depression management for affected patients.
Background:
Depression is common in patients with ischaemic heart disease and preoperative depression is a risk factor following coronary artery bypass grafting. The American Heart Association recommends depression screening in all patients with heart disease. Our aim was to assess the feasibility and results of a depression screening program in cardiac surgery patients.
Methods:
We introduced a depression screening project at the cardiac surgery department at Karolinska University Hospital and included patients between 2013 and 2016. Patients scheduled for elective surgery recieved the Patient Health Questionnaire (PHQ-9), a depression screening instrument, by mail approximately 2weeks before surgery. Urgent patients recieved the PHQ-9 on the ward. Baseline characteristics, medical history, and medications were collected from patient charts, and entered into a study database together with the results from the PHQ-9 questionaires.
Results:
During the study period, 2,512 patients underwent cardiac sugery; 1,133 (45%) completed PHQ-9. The response-rate in patients scheduled for elective surgery was 64%, and 15% in urgent patients. Fifteen per cent (15%) had a PHQ-9 score ≥10 suggestive of major depression. Reporting a PHQ-9 score ≥10 was twice as common in women as in men (23% vs 12%).
Conclusions:
Systematic depression screening using PHQ-9 in cardiac surgery patients was feasible and not very resource-intensive. The project showed a satisfactory response-rate in elective patients, but adjustments to increase the response-rate in urgent patients are needed. Future studies should investigate if and how patients with symptoms of depression would benefit from depression management.
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