Rapid screening for major depression in post-myocardial infarction patients: an investigation using Beck Depression Inventory II items

Abstract

To determine the ability of three questions from the Beck Depression Inventory II (BDI-II) to detect major depressive disorder (MDD) in a cohort of patients hospitalised for acute myocardial infarction (MI). Prospective observational study. Coronary care unit and cardiac step-down unit of an urban academic medical centre. 131 post-MI patients within 72 h of symptom onset. Patients were administered the BDI-II and participated in a structured diagnostic interview for MDD. Three individual BDI-II items (regarding sadness, loss of interest and loss of pleasure) were examined individually and in two-question combinations to determine their ability to screen for MDD. Sensitivity, specificity, negative and positive predictive values and proportion of patients with MDD correctly identified. The individual items and two-question combinations had good sensitivity (76-94%), specificity (70-88%) and negative predictive values (97-99%). Item 1 (sadness) performed the best of the individual items (48% with a positive response to the item had MDD; 3% with a negative response had MDD; over 80% of patients with MDD were correctly identified). A combination of questions about sadness and loss of interest performed best among the two-question combinations (37% with positive response had MDD v 1% with a negative response; 94% of patients with MDD were identified). One to two questions regarding sadness and loss of interest serve as simple and effective screening tools for post-MI depression.