SCREENING FOR CLINICAL DEPRESSION IN IRANIAN POST-MI PATIENTS USING THE BECK DEPRESSION INVENTORY FOR PRIMARY CARE

Abstract    INTRODUCTION: Clinical depression is common among post-myocardial infarction (MI) patients. There is a need for a suitable instrument independent of MI characteristics to screen MI patients for depression. The purpose of this study was to ascertain psychometric properties of the Beck Depression Inventory for Primary Care (BDI-PC) in screening for clinical depression (including major and minor depressive disorders) in the post-MI patients who were scheduled for routine office visits with cardiologists.    METHOD: The BDI-PC and hospital anxiety and depression scale (HADS) were administered to ۱۷۶ post-MI patients admitted to the CCU wards of nine hospitals in Isfahan, Iran. Also the structured interview for DSM-IV, considering DSM­IV criteria for major and minor depressive disorder, was used to diagnose clinical depression.    RESULTS: The internal consistency of the BDI-PC was high (Cronbach's alpha: ۰.۸۸), and the construct validity of BDI-PC was confirmed against depression subscale of HADS (r=۰.۸۶.۸). A BDI-PC cutoff score of ۵ and above yielded ۹۱% maximum clinical efficiency with ۸۴% (۹۵% CI ۷۹%-۹۰%) sensitivity and ۹۷% (۹۵% CI ۹۴%-۹۹%) specificity rates, respectively, for identifying patients with and without clinical depression.    CONCLUSION: The BDI-PC proved an effective case-finding instrument in screening for clinical depression in post-MI patients.      Keywords: Myocardial infarction, Depression, Screening, BDI-PC.