Depression and anxiety among coronary heart disease patients: can affect dimensions and theory inform diagnostic disorder-based screening?

J Clin Psychol. 2012 Apr;68(4):448-61. doi: 10.1002/jclp.21828. Epub 2012 Feb 3.

Abstract

Objectives: To examine the association between low positive affect, somatic anxiety and general distress with affective disorders, anxious misery, and visceral fear among coronary heart disease patients.

Participants: Patients awaiting a coronary revascularization procedure (N = 158; 20.9% female; median age = 65, interquartile range 58-73) underwent structured interview with the Mini-International Neuropsychiatric Interview. Patients completed a brief version of the Mood and Anxiety Symptom Questionnaire (i.e., Anxiety Depression Distress Inventory-27) and a measure of Type D personality.

Results: Somatic anxiety scores yielded an area under the curve (AUC) = .784 and 75.0% sensitivity and 68.5% specificity in relation to panic disorder. Low positive affect yielded AUC = .811 and 70.4% sensitivity and 77.1% specificity for major depression. General distress yielded AUC = .795 and 75.0% sensitivity and 72.5% specificity for generalized anxiety disorder. No affective dimension was optimally associated with the anxious misery or visceral fear cluster. Trait negative affect was not a suitable screener for any disorder.

Conclusions: The Anxiety Depression Distress Inventory-27 dimensions of low positive affect and somatic anxiety provided optimal detection of depression and panic disorder, respectively, as hypothesized, supporting discriminant validity.

Keywords: coronary heart disease; depression; generalized anxiety disorder; panic disorder; receiver operating characteristics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anxiety Disorders / diagnosis*
  • Cluster Analysis
  • Coronary Disease / classification
  • Coronary Disease / diagnosis*
  • Coronary Disease / psychology*
  • Depressive Disorder, Major / diagnosis*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Panic Disorder / diagnosis
  • Phobic Disorders / diagnosis
  • Psychiatric Status Rating Scales
  • Psychological Theory
  • ROC Curve
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Stress Disorders, Post-Traumatic / diagnosis*