Depression Screening and Treatment Recall in Male and Female Coronary Artery Disease Inpatients: Association with Symptoms One Year Later

Background: Guidelines and statements recommend cardiac patients to be screened for depression. This study examined whether cardiac inpatients recall depression screening, how the recollection varies by gender, and how it is related to depressive symptoms and treatment one year later. Methods: 2635 cardiac inpatients from 11 hospitals across Ontario, Canada completed a survey and were mailed a follow-up survey one year later. The in-hospital survey queried patients about depression screening since their cardiac diagnosis, whether they had ever been diagnosed with depression, and if yes, what treatments they were recommended. Both surveys included the Beck Depression Inventory-II (BDI-II)to assess depressive symptoms. Results: Of the 1809 (68.7%) retained participants, 513 (30.0%) participants recalled depression screening and they were significantly more likely to be male. Screening recall was not significantly related to depressive symptoms at both time points(P>0.05). Participants who were recommended anti depressants had higher BDI-II scores than those who were not recommended antidepressants, both as inpatients (P<0.01) and one year later (P<0.05).There was no significant change in depressive symptoms over time in patients who received any type of therapy (P > 0.05).Conclusion: Less than one-third of cardiac inpatients recalled being screened for depression. Recall of screening was not significantly related to depressive symptoms, and use of treatment was related to greater symptoms. Improved patient-provider communication regarding depression screening in cardiac patients is warranted, as well as better monitoring of treatment response in clinical practice.