The advisory brought to practice: routine screening on depression (and anxiety) in coronary heart disease; consequences and implications

INTRODUCTION: Following the evidence, the American Heart Association recently published a Science Advisory with the recommendation that patients with Coronary Heart Disease (CHD) should be screened for depressive symptoms and depression. Also the Heart Failure Guidelines recommend routine screening for depressive symptoms. Screening for anxiety was not included in these recommendations, despite findings in literature suggesting that cardiac patients are at risk for high levels of anxiety.

OBJECTIVE: The aim of the current study is to obtain a realistic estimation of the consequences and implications of this advice for clinical practice.

METHOD: Data on anxiety, and depression, need for help, demographics and disease related variables were collected in a cross-sectional study within a 2-month period (July-August 2008) at the cardiac outpatient clinic of the University Medical Center Groningen (The Netherlands).

PATIENTS: Data of 217 patients were analyzed, mean age was 58years (±16) and 62% of the respondents were male.

RESULTS: Of 217 patients, 26% indicated to have depressive symptoms and 42% indicated elevated levels of anxiety. About 35-50% of these patients indicated a moderate to high need for help. The prevalence of anxiety and depression was mainly associated with demographic factors and the occurrence of stressful life events.

CONCLUSION: Routine screening will put an increased demand on psychosocial diagnostics and treatment, therefore the availability of professionals should be guaranteed in advance.