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Published in: Health and Quality of Life Outcomes 1/2012

Open Access 01-12-2012 | Short report

Cardiac Depression Scale: Mokken scaling in heart failure patients

Authors: Chantal F Ski, David R Thompson, David L Hare, Andrew G Stewart, Roger Watson

Published in: Health and Quality of Life Outcomes | Issue 1/2012

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Abstract

Background

There is a high prevalence of depression in patients with heart failure (HF) that is associated with worsening prognosis. The value of using a reliable and valid instrument to measure depression in this population is therefore essential. We validated the Cardiac Depression Scale (CDS) in heart failure patients using a model of ordinal unidimensional measurement known as Mokken scaling.

Findings

We administered in face-to-face interviews the CDS to 603 patients with HF. Data were analysed using Mokken scale analysis. Items of the CDS formed a statistically significant unidimensional Mokken scale of low strength (H<0.40) and high reliability (Rho>0.8).

Conclusions

The CDS has a hierarchy of items which can be interpreted in terms of the increasingly serious effects of depression occurring as a result of HF. Identifying an appropriate instrument to measure depression in patients with HF allows for early identification and better medical management.
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Literature
1.
go back to reference Bui AL, Horwich TB, Fonarrow GC: Epidemiology and risk profile of heart failure. Nat Rev Cardiol 2011, 8: 30–41. 10.1038/nrcardio.2010.165PubMedCentralCrossRef Bui AL, Horwich TB, Fonarrow GC: Epidemiology and risk profile of heart failure. Nat Rev Cardiol 2011, 8: 30–41. 10.1038/nrcardio.2010.165PubMedCentralCrossRef
2.
go back to reference Biermann J, Neumann T, Angermann CE, Erbel R, Maisch B, Pittrow D, Regitz-Zagrosek V, Scheffold T, Wachter R, Gelbrich G, Wasem J, Neumann A: Economic burden of patients with various etiologies of chronic systolic heart failure analysed by resource use and costs. Int J Cardiol 2012, 156: 323–325. 10.1016/j.ijcard.2012.01.099CrossRef Biermann J, Neumann T, Angermann CE, Erbel R, Maisch B, Pittrow D, Regitz-Zagrosek V, Scheffold T, Wachter R, Gelbrich G, Wasem J, Neumann A: Economic burden of patients with various etiologies of chronic systolic heart failure analysed by resource use and costs. Int J Cardiol 2012, 156: 323–325. 10.1016/j.ijcard.2012.01.099CrossRef
3.
go back to reference Braunschweig F, Cowie MR, Auricchio A: What are the costs of heart failure? Europace 2011, 13: ii13-ii17. 10.1093/europace/eur081 Braunschweig F, Cowie MR, Auricchio A: What are the costs of heart failure? Europace 2011, 13: ii13-ii17. 10.1093/europace/eur081
4.
go back to reference Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, Ferguson TB, Ford E, Furie K, Gillespie C, Go A, Greenlund K, Haase N, Hailpern S, Ho PM, Howard V, Kissela B, Kittner S, Lackland D, Lisabeth L, Marelli A, McDermott MM, Meigs J, Mozaffarian D, Mussolino M, Nichol G, Roger VL, Rosamond W, Sacco R, Sorlie P: Heart disease and stroke statistics - 2010 update: a report from the American Heart Association. Circulation 2010, 121: e46-e215.CrossRef Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, Ferguson TB, Ford E, Furie K, Gillespie C, Go A, Greenlund K, Haase N, Hailpern S, Ho PM, Howard V, Kissela B, Kittner S, Lackland D, Lisabeth L, Marelli A, McDermott MM, Meigs J, Mozaffarian D, Mussolino M, Nichol G, Roger VL, Rosamond W, Sacco R, Sorlie P: Heart disease and stroke statistics - 2010 update: a report from the American Heart Association. Circulation 2010, 121: e46-e215.CrossRef
5.
go back to reference Sherwood A, Blumenthal JA, Hinderliter AL, Koch GG, Adams KF Jr, Dupree CS, Bensimhon DR, Johnson KS, Trivedi R, Bowers M, Christenson RH, O’Connor CM: Worsening depressive symptoms are associated with adverse clinical outcomes in patients with heart failure. J Am Coll Cardiol 2011, 57: 418–423. 10.1016/j.jacc.2010.09.031PubMedCentralCrossRef Sherwood A, Blumenthal JA, Hinderliter AL, Koch GG, Adams KF Jr, Dupree CS, Bensimhon DR, Johnson KS, Trivedi R, Bowers M, Christenson RH, O’Connor CM: Worsening depressive symptoms are associated with adverse clinical outcomes in patients with heart failure. J Am Coll Cardiol 2011, 57: 418–423. 10.1016/j.jacc.2010.09.031PubMedCentralCrossRef
6.
go back to reference Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ: Depression in heart failure: a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol 2006, 48: 1527–1537.CrossRef Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ: Depression in heart failure: a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol 2006, 48: 1527–1537.CrossRef
7.
go back to reference Johnson TJ, Basu S, Pisani BA, Avery EF, Mendez JC, Calvin JE, Powell LH: Depression predicts repeated heart failure hospitalizations. J Cardiac Fail 2012, 18: 246–252. 10.1016/j.cardfail.2011.12.005CrossRef Johnson TJ, Basu S, Pisani BA, Avery EF, Mendez JC, Calvin JE, Powell LH: Depression predicts repeated heart failure hospitalizations. J Cardiac Fail 2012, 18: 246–252. 10.1016/j.cardfail.2011.12.005CrossRef
8.
go back to reference Jiang W, Alexander J, Christopher E, Kuchibhatla M, Gaulden L, Cuffe MS, Blazing MA, Davenport C, Califf RM, Krishnan RR, O’Connor CM: Relationship of depression to increased mortality and rehospitalisation in patients with congestive heart failure. Arch Intern Med 2001, 161: 1849–1856. 10.1001/archinte.161.15.1849CrossRef Jiang W, Alexander J, Christopher E, Kuchibhatla M, Gaulden L, Cuffe MS, Blazing MA, Davenport C, Califf RM, Krishnan RR, O’Connor CM: Relationship of depression to increased mortality and rehospitalisation in patients with congestive heart failure. Arch Intern Med 2001, 161: 1849–1856. 10.1001/archinte.161.15.1849CrossRef
9.
go back to reference Shimizu Y, Yamada S, Miyake F, Izumi T: The effects of depression on the course of functional limitations in patients with chronic heart failure. J Cardiac Fail 2011, 17: 503–510. 10.1016/j.cardfail.2011.01.005CrossRef Shimizu Y, Yamada S, Miyake F, Izumi T: The effects of depression on the course of functional limitations in patients with chronic heart failure. J Cardiac Fail 2011, 17: 503–510. 10.1016/j.cardfail.2011.01.005CrossRef
10.
go back to reference Rumsfeld JS, Havranek E, Masoudi FA, Peterson ED, Jones P, Tooley JF, Krumholz HM, Spertus JA: Cardiovascular Outcomes Research Consortium. Depressive symptoms are the strongest predictors of short-term declines in health status in patients with heart failure. J Am Coll Cardiol 2003, 42: 1811–1817. 10.1016/j.jacc.2003.07.013CrossRef Rumsfeld JS, Havranek E, Masoudi FA, Peterson ED, Jones P, Tooley JF, Krumholz HM, Spertus JA: Cardiovascular Outcomes Research Consortium. Depressive symptoms are the strongest predictors of short-term declines in health status in patients with heart failure. J Am Coll Cardiol 2003, 42: 1811–1817. 10.1016/j.jacc.2003.07.013CrossRef
11.
go back to reference Rollman BL, Helbeck Belnap BH, Mazumdar S, Houck PR, HE F, Alvarez RJ, Schulberg HC, Reynolds CF 3rd, McNamara DM: A positive 2-Item Patient Health Questionnaire depression screen among hospitalized heart failure patients is associated with elevated 12-month mortality. J Cardiac Fail 2012, 18: 238–245. 10.1016/j.cardfail.2011.11.002CrossRef Rollman BL, Helbeck Belnap BH, Mazumdar S, Houck PR, HE F, Alvarez RJ, Schulberg HC, Reynolds CF 3rd, McNamara DM: A positive 2-Item Patient Health Questionnaire depression screen among hospitalized heart failure patients is associated with elevated 12-month mortality. J Cardiac Fail 2012, 18: 238–245. 10.1016/j.cardfail.2011.11.002CrossRef
12.
go back to reference Macchia A, Monte S, Pellegrini F, Romero M, D’Ettorre A, Tavazzi L, Tognoni G, Maggioni AP: Depression worsens outcomes in elderly patients with heart failure: An analysis of 48,117 patients in a community setting. Eur J Heart Fail 2008, 10: 714–721. 10.1016/j.ejheart.2008.05.011CrossRef Macchia A, Monte S, Pellegrini F, Romero M, D’Ettorre A, Tavazzi L, Tognoni G, Maggioni AP: Depression worsens outcomes in elderly patients with heart failure: An analysis of 48,117 patients in a community setting. Eur J Heart Fail 2008, 10: 714–721. 10.1016/j.ejheart.2008.05.011CrossRef
13.
go back to reference Hallas CN, Wray J, Andreou P, Banner N: Depression and perceptions about heart failure predict quality of life in patients with advanced heart failure. Heart Lung 2011, 40: 111–121. 10.1016/j.hrtlng.2009.12.008CrossRef Hallas CN, Wray J, Andreou P, Banner N: Depression and perceptions about heart failure predict quality of life in patients with advanced heart failure. Heart Lung 2011, 40: 111–121. 10.1016/j.hrtlng.2009.12.008CrossRef
14.
go back to reference Lichtman JH, Bigger JT, Blumenthal JA, Frasure-Smith N, Kaufmann PG, Lespérance F, Mark DB, Sheps DS, Taylor CB, Froelicher ES, American Heart Association Prevention Committee of the Council on Cardiovascular Nursing; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Epidemiology and Prevention; American Heart Association Interdisciplinary Council on Quality of Care and Outcomes Research; American Psychiatric Association: Depression and coronary heart disease: recommendations for screening, referral, and treatment. A science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research. Circulation 2008, 118: 1768–1775. 10.1161/CIRCULATIONAHA.108.190769CrossRef Lichtman JH, Bigger JT, Blumenthal JA, Frasure-Smith N, Kaufmann PG, Lespérance F, Mark DB, Sheps DS, Taylor CB, Froelicher ES, American Heart Association Prevention Committee of the Council on Cardiovascular Nursing; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Epidemiology and Prevention; American Heart Association Interdisciplinary Council on Quality of Care and Outcomes Research; American Psychiatric Association: Depression and coronary heart disease: recommendations for screening, referral, and treatment. A science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research. Circulation 2008, 118: 1768–1775. 10.1161/CIRCULATIONAHA.108.190769CrossRef
15.
go back to reference Celano CM, Huffman JC: Depression and cardiac disease: a review. Cardiol Rev 2011, 19: 130–142. 10.1097/CRD.0b013e31820e8106CrossRef Celano CM, Huffman JC: Depression and cardiac disease: a review. Cardiol Rev 2011, 19: 130–142. 10.1097/CRD.0b013e31820e8106CrossRef
16.
go back to reference Donohue JM, Pincus HA: Reducing the societal burden of depression: a review of economic costs, quality of care and effects of treatment. PharmacoEconomics 2007, 25: 7–24. 10.2165/00019053-200725010-00003CrossRef Donohue JM, Pincus HA: Reducing the societal burden of depression: a review of economic costs, quality of care and effects of treatment. PharmacoEconomics 2007, 25: 7–24. 10.2165/00019053-200725010-00003CrossRef
17.
go back to reference Richards D: Prevalence and clinical course of depression: a review. Clin Psychol Rev 2011, 31: 1117–1125. 10.1016/j.cpr.2011.07.004CrossRef Richards D: Prevalence and clinical course of depression: a review. Clin Psychol Rev 2011, 31: 1117–1125. 10.1016/j.cpr.2011.07.004CrossRef
18.
go back to reference Swoden GL, Huffman JC: The impact of mental illness on cardiac outcomes: a review for the cardiologist. Int J Cardiol 2009, 132: 30–37. 10.1016/j.ijcard.2008.10.002CrossRef Swoden GL, Huffman JC: The impact of mental illness on cardiac outcomes: a review for the cardiologist. Int J Cardiol 2009, 132: 30–37. 10.1016/j.ijcard.2008.10.002CrossRef
19.
go back to reference Whooley MA: To screen or not to screen? Depression in patients with cardiovascular disease. J Am Coll Cardiol 2009, 54: 891–893. 10.1016/j.jacc.2009.05.034CrossRef Whooley MA: To screen or not to screen? Depression in patients with cardiovascular disease. J Am Coll Cardiol 2009, 54: 891–893. 10.1016/j.jacc.2009.05.034CrossRef
20.
go back to reference Thombs BD, de Jonge P, Coyne JC, Whooley MA, Frasure-Smith N, Mitchell AJ, Zuidersma M, Eze-Nliam C, Lima BB, Smith CG, Soderlund K, Ziegelstein RC: Depression screening and patient outcomes in cardiovascular care. JAMA 2008, 300: 2161–2171. 10.1001/jama.2008.667CrossRef Thombs BD, de Jonge P, Coyne JC, Whooley MA, Frasure-Smith N, Mitchell AJ, Zuidersma M, Eze-Nliam C, Lima BB, Smith CG, Soderlund K, Ziegelstein RC: Depression screening and patient outcomes in cardiovascular care. JAMA 2008, 300: 2161–2171. 10.1001/jama.2008.667CrossRef
21.
go back to reference Ziegelstein RC, Thombs BD, Coyne JC, de Jonge P: Routine screening for depression in patients with coronary heart disease. J Am Coll Cardiol 2009, 54: 886–890. 10.1016/j.jacc.2009.01.082PubMedCentralCrossRef Ziegelstein RC, Thombs BD, Coyne JC, de Jonge P: Routine screening for depression in patients with coronary heart disease. J Am Coll Cardiol 2009, 54: 886–890. 10.1016/j.jacc.2009.01.082PubMedCentralCrossRef
22.
go back to reference Holmes SD: American Heart Association guidelines for depression in screening in heart disease: call to action for the research community? J Psychosom Res 2011, 71: 1–2. 10.1016/j.jpsychores.2011.03.008CrossRef Holmes SD: American Heart Association guidelines for depression in screening in heart disease: call to action for the research community? J Psychosom Res 2011, 71: 1–2. 10.1016/j.jpsychores.2011.03.008CrossRef
23.
go back to reference Hasnain M, Vieweg WVR, Lesnefsky EJ, Pandurangi AK: Depression screening in patients with coronary heart disease: a critical evaluation of the AHA guidelines. J Psychosom Res 2011, 71: 6–12. 10.1016/j.jpsychores.2010.10.009CrossRef Hasnain M, Vieweg WVR, Lesnefsky EJ, Pandurangi AK: Depression screening in patients with coronary heart disease: a critical evaluation of the AHA guidelines. J Psychosom Res 2011, 71: 6–12. 10.1016/j.jpsychores.2010.10.009CrossRef
24.
go back to reference Hare DL, Davis CL: Cardiac depression scale: validation of a new depression scale for cardiac patients. J Psychosom Res 1996, 40: 379–386. 10.1016/0022-3999(95)00612-5CrossRef Hare DL, Davis CL: Cardiac depression scale: validation of a new depression scale for cardiac patients. J Psychosom Res 1996, 40: 379–386. 10.1016/0022-3999(95)00612-5CrossRef
25.
go back to reference Hare DL: Imipramine in patients with chest pain despite normal coronary angiograms. N Engl J Med 1994, 330: 882. Hare DL: Imipramine in patients with chest pain despite normal coronary angiograms. N Engl J Med 1994, 330: 882.
26.
go back to reference Shi WY, Stewart AG, Hare DL: Major depression in cardiac patients is accurately assessed using the Cardiac Depression Scale. Psychother Psychosom 2010, 79: 391–392. 10.1159/000320897CrossRef Shi WY, Stewart AG, Hare DL: Major depression in cardiac patients is accurately assessed using the Cardiac Depression Scale. Psychother Psychosom 2010, 79: 391–392. 10.1159/000320897CrossRef
27.
go back to reference Birks Y, Roebuck A, Thompson DR: A validation study of the Cardiac Depression Scale (CDS) in a UK population. Br J Health Psychol 2004, 9: 15–24. 10.1348/135910704322778696CrossRef Birks Y, Roebuck A, Thompson DR: A validation study of the Cardiac Depression Scale (CDS) in a UK population. Br J Health Psychol 2004, 9: 15–24. 10.1348/135910704322778696CrossRef
28.
go back to reference Di Benedetto M, Lindner H, Hare DL, Kent S: Depression following acute coronary syndromes: a comparison between the Cardiac Depression Scale and the Beck Depression Inventory II. J Psychosom Res 2006, 60: 13–20. 10.1016/j.jpsychores.2005.06.003CrossRef Di Benedetto M, Lindner H, Hare DL, Kent S: Depression following acute coronary syndromes: a comparison between the Cardiac Depression Scale and the Beck Depression Inventory II. J Psychosom Res 2006, 60: 13–20. 10.1016/j.jpsychores.2005.06.003CrossRef
29.
go back to reference Wise FM, Harris DW, Carter LM: Validation of the Cardiac Depression Scale in a cardiac rehabilitation population. J Psychosom Res 2006, 60: 177–183. 10.1016/j.jpsychores.2005.07.019CrossRef Wise FM, Harris DW, Carter LM: Validation of the Cardiac Depression Scale in a cardiac rehabilitation population. J Psychosom Res 2006, 60: 177–183. 10.1016/j.jpsychores.2005.07.019CrossRef
30.
go back to reference Hemker BT, Sijtsma K: Selection of unidimensional scales from a multidimensional item bank in the polytmous Mokken IRT model. App Psychol Meas 1995, 19: 337–352. 10.1177/014662169501900404CrossRef Hemker BT, Sijtsma K: Selection of unidimensional scales from a multidimensional item bank in the polytmous Mokken IRT model. App Psychol Meas 1995, 19: 337–352. 10.1177/014662169501900404CrossRef
31.
go back to reference Sijtsma K, Molenaar IW: An introduction to nonparametric item response theory. Thousand Oaks, CA: Sage; 2002. Sijtsma K, Molenaar IW: An introduction to nonparametric item response theory. Thousand Oaks, CA: Sage; 2002.
32.
go back to reference Sijtsma K, Meijer RR, van der Ark L: Mokken scale analysis as time goes by: an update for scaling practitioners. Pers Ind Diff 2011, 50: 31–37. 10.1016/j.paid.2010.08.016CrossRef Sijtsma K, Meijer RR, van der Ark L: Mokken scale analysis as time goes by: an update for scaling practitioners. Pers Ind Diff 2011, 50: 31–37. 10.1016/j.paid.2010.08.016CrossRef
33.
go back to reference Sijtsma K, Junker BW: A survey of theory and methods of invariant item ordering. Brit J Math Stat Psychol 1996, 49: 79–105. 10.1111/j.2044-8317.1996.tb01076.xCrossRef Sijtsma K, Junker BW: A survey of theory and methods of invariant item ordering. Brit J Math Stat Psychol 1996, 49: 79–105. 10.1111/j.2044-8317.1996.tb01076.xCrossRef
34.
go back to reference Stewart ME, Watson R, Clark A, Ebmeier KP, Deary IJ: A hierarchy of happiness? Mokken scaling analysis of the Oxford Happiness Inventory. Pers Ind Diff 2010, 48: 845–848. 10.1016/j.paid.2010.02.011CrossRef Stewart ME, Watson R, Clark A, Ebmeier KP, Deary IJ: A hierarchy of happiness? Mokken scaling analysis of the Oxford Happiness Inventory. Pers Ind Diff 2010, 48: 845–848. 10.1016/j.paid.2010.02.011CrossRef
35.
go back to reference Watson R, Deary I, Austin E: Are personality trait items reliably more or less ‘difficult’? Mokken scaling of the NEO-FFI. Pers Ind Diff 2007, 43: 1460–1469. 10.1016/j.paid.2007.04.023CrossRef Watson R, Deary I, Austin E: Are personality trait items reliably more or less ‘difficult’? Mokken scaling of the NEO-FFI. Pers Ind Diff 2007, 43: 1460–1469. 10.1016/j.paid.2007.04.023CrossRef
36.
go back to reference Watson R, Deary IJ, Shipley B: A hierarchy of distress: Mokken scaling of the GHQ-30. Psychol Med 2008, 28: 575–579. Watson R, Deary IJ, Shipley B: A hierarchy of distress: Mokken scaling of the GHQ-30. Psychol Med 2008, 28: 575–579.
37.
go back to reference Watson R, Wang W, Hare DL, Ski CF, Thompson DR: The Chinese version of the Cardiac Depression Scale: Mokken scaling. Health Qual Life Outcomes 2012, 10: 1–4. 10.1186/1477-7525-10-1CrossRef Watson R, Wang W, Hare DL, Ski CF, Thompson DR: The Chinese version of the Cardiac Depression Scale: Mokken scaling. Health Qual Life Outcomes 2012, 10: 1–4. 10.1186/1477-7525-10-1CrossRef
38.
go back to reference Watson R, Wang W, Ski CF, Thompson DR: The Chinese version of the Myocardial Infarction Dimensional Scale: Mokken scaling. Health Qual Life Outcomes 2012, 10: 2–4. 10.1186/1477-7525-10-2PubMedCentralCrossRef Watson R, Wang W, Ski CF, Thompson DR: The Chinese version of the Myocardial Infarction Dimensional Scale: Mokken scaling. Health Qual Life Outcomes 2012, 10: 2–4. 10.1186/1477-7525-10-2PubMedCentralCrossRef
39.
go back to reference Molenaar IW, Sijtsma K: Users manual MSP5 for Windows: a program for Mokken scale analysis for polytomous items. Groningen: iec ProGAMMA; 2000. Molenaar IW, Sijtsma K: Users manual MSP5 for Windows: a program for Mokken scale analysis for polytomous items. Groningen: iec ProGAMMA; 2000.
40.
go back to reference van der Ark LA: Mokken scale analysis in R. J Stat Soft 2007, 20: 1–19. van der Ark LA: Mokken scale analysis in R. J Stat Soft 2007, 20: 1–19.
41.
go back to reference Meijer RR, Baneke JJ: Analyzing psychopathology items: a case for nonparametric item response theory modelling. Psychol Methods 2001, 9: 354–368.CrossRef Meijer RR, Baneke JJ: Analyzing psychopathology items: a case for nonparametric item response theory modelling. Psychol Methods 2001, 9: 354–368.CrossRef
Metadata
Title
Cardiac Depression Scale: Mokken scaling in heart failure patients
Authors
Chantal F Ski
David R Thompson
David L Hare
Andrew G Stewart
Roger Watson
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2012
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-10-141

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