Purpose: 

Depression affects cardiac health and is important to track within cardiac rehabilitation (CR). Using two depression screeners within one sample, we calculated prevalence of baseline depressive symptomology, improvements during CR, and predictors of both.

Methods: 

Data were drawn from the University of Vermont Medical Center CR program prospectively collected database. A total of 1781 patients who attended between January 2011 and July 2019 were included. Two depression screeners (Geriatric Depression Scale-Short Form [GDS-SF] and Patient Health Questionnaire-9 [PHQ-9]) were compared on proportion of the sample categorized with ≥ mild or moderate levels of depressive symptoms (PHQ-9 ≥5, ≥10; GDS-SF ≥6, ≥10). Changes in depressive symptoms by screener were examined within patients who had completed ≥9 sessions of CR. Patient characteristics associated with depressive symptoms at entry, and changes in symptoms were identified.

Results: 

Within those who completed ≥9 sessions of CR with exit scores on both screeners (n = 1201), entrance prevalence of ≥ mild and ≥ moderate depressive symptoms differed by screener (32% and 9% PHQ-9; 12% and 3% GDS-SF; both P< .001). Patients who were younger, female, with lower cardiorespiratory fitness (CRF) scores were more likely to have ≥ mild depressive symptoms at entry. Most patients with ≥ mild symptoms decreased severity by ≥1 category by exit (PHQ-9 = 73%; GDS-SF = 77%). Nonsurgical diagnosis and lower CRF were associated with less improvement in symptoms on the PHQ-9 (both P< .05).

Conclusion: 

Our results provide initial benchmarks of depressive symptoms in CR. They identify younger patients, women, patients with lower CRF, and those with nonsurgical diagnosis as higher risk groups for having depressive symptoms or lack of improvement in symptoms.

中文翻译：

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心脏康复中抑郁症状的基准测试

目的： 

抑郁症会影响心脏健康，因此在心脏康复 (CR) 中进行追踪非常重要。我们在一个样本中使用两个抑郁症筛查仪，计算了基线抑郁症状的患病率、CR 期间的改善情况以及两者的预测因子。

方法： 

数据取自佛蒙特大学医学中心 CR 项目前瞻性收集的数据库。总共纳入了 2011 年 1 月至 2019 年 7 月期间就诊的 1781 名患者。比较两种抑郁症筛查工具（老年抑郁量表简表 [GDS-SF] 和患者健康问卷 9 [PHQ-9]），比较被分类为≥轻度或中度抑郁症状的样本比例（PHQ-9 ≥5） ，≥10；GDS-SF≥6，≥10）。筛查者对已完成 ≥9 次 CR 疗程的患者进行了抑郁症状的变化检查。确定了与入院时抑郁症状相关的患者特征以及症状的变化。

结果： 

在完成 ≥9 次 CR 且两位筛查者均获得退出分数的患者中 (n = 1201)，≥ 轻度和 ≥ 中度抑郁症状的入学患病率因筛查者而异（32% 和 9% PHQ-9；12% 和 3% GDS） -SF；两者P < .001）。年轻、女性、心肺健康 (CRF) 评分较低的患者在入院时更有可能出现≥轻度抑郁症状。大多数症状≥轻度的患者在退出时严重程度降低了≥1类（PHQ-9 = 73%；GDS-SF = 77%）。非手术诊断和较低的 CRF 与 PHQ-9 症状改善较少相关（均P < .05）。

结论： 

我们的结果提供了 CR 抑郁症状的初步基准。他们将年轻患者、女性、CRF 较低的患者以及非手术诊断患者确定为出现抑郁症状或症状缺乏改善的高风险群体。