Longitudinal changes in depression screening results in cardiac surgery patients

The aim was to investigate longitudinal changes in depression screening results by sex up to one year following cardiac surgery.

We introduced a depression screening project using the Patient Health Questionnaire (PHQ-9) including patients between 2013-2016. Patients received the PHQ-9 prior to surgery, and at follow-up one year after surgery. We analyzed changes in PHQ-9 scores and screening status from baseline to 1-year follow-up.

Screening results were obtained in 1,133 patients prior to surgery, and after one year, 1,084 patients were alive and of those 897 (83%) patients completed the follow-up PHQ-9 questionnaire. A positive depression screen at baseline was twice as common in women compared to men. A total of 547 (92%) men and 173 (91%) women who were screening negative at baseline were still screening negative at 1-year follow-up. There was no difference between men and women. A lower proportion of men compared with women (44% vs. 61%) improved from screening positive at baseline to screening negative at 1-year follow-up (P=0.069). The total PHQ-9 score difference between baseline and one year had increased with 0.23 points among men and decreased with 0.68 points in women.

We found that twice as many women as men had a positive depression screen at baseline, and that almost 10% of all who were screening negative at baseline, were screening positive after one year. An improvement in depressive symptoms (transition from a screening positive state to a negative screening state) was more common among women than men after one year of follow up.