The Hospital Anxiety and Depression Scale depression subscale, but not the Beck Depression Inventory-Fast Scale, identifies patients with acute coronary syndrome at elevated risk of 1-year mortality

Challenges in reducing depression-related mortality in cardiac populations: cognition, emotion, fatigue or personality?

“…Rieckmann et al (2006) demonstrated that mildly to moderately/severely depressed patients with ACS had significantly higher levels of dysfunctional attitudes compared to non-depressed ACS patients. Although depression has been associated with morbidity and mortality following CHD, subsequent research questioned whether cognitive symptoms of depression were associated with mortality, or whether only somatic symptoms predicted outcomes (Table 1) (de Jonge, Ormel, et al, 2006;Doyle et al, 2006). Furthermore, there is also evidence to suggest that symptoms of depression in post-MI patients are both quantitatively and qualitatively different from symptoms observed in psychiatric patients, with cardiac patients showing fewer distorted cognitions (Martens et al, 2006).…”

“…Therefore, the trial would not have been powered to find the difference in the sub-group for which it was most suited. Also, since cognitive depressive symptoms are not associated with subsequent mortality (de Jonge, Ormel, et al, 2006;Doyle et al, 2006), it is perhaps unsurprising that the treatment of these symptoms through CBT had no impact on cardiovascular outcomes.…”

“…One main difference may be that vital exhaustion does not seem to measure anhedonia (apart perhaps from one item on sex). This may be crucial as anhedonia has specifically been linked to increased cardiovascular risk (Doyle et al, 2006). Furthermore, vital exhaustion appears to have substantial overlap with positive and negative emotion (as characterised by the GMS and assuming that positive/negative emotion is a univariate construct), with 14 vital exhaustion items corresponding to 18 GMS items ( Table 2).…”

Latent structure of the Hospital Anxiety And Depression Scale: A 10-year systematic review

“…However, the Hospital Anxiety and Depression Scale (HADS) was created specifically to accomplish this task and to assess possible and probable cases of anxiety and depression in non-psychiatric hospital outpatients (4). The HADS is an important psychometric tool in the assessment of individuals with somatic illnesses, notably for coronary heart disease patients, predicting cardiovascular morbidity and mortality (5,6). The 14-item HADS is composed of two 7-item subscales, the HADS-A and HADS-D, intended to measure mutually exclusive levels of anxiety and depression, respectively.…”

Why the HADS is still important: Reply to Coyne & van Sonderen

“…The HADS depression subscale seems to be a powerful predictor of one year morbidity and mortality 3,4 , and even 8-year mortality 5 in patients with acute coronary syndrome. This may appear initially unremarkable, given the wellestablished association between distress and cardiovascular prognosis 6,7 .…”