Using the Short Form-36 mental summary score as an indicator of depressive symptoms in patients with coronary heart disease
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Depression is common in patients with cardiac disease; however, the use of depression-specific health instruments is limited by their increased responder and analyst burden. The study aimed to define a threshold value on the Short Form-36 (SF-36) mental component summary score (MCS) that identified depressed cardiac patients as measured by the Centre for Epidemiologic Studies Depression Scale (CES-D).
An optimal threshold was determined using receiver-operating characteristic (ROC) curves on SF-36 and CES-D data from a large cardiac cohort (N = 1,221). The performance of this threshold was evaluated in a further two cardiac populations.
In the index cohort, an SF-36 MCS score of ≤45 was revealed as an optimal threshold according to maximal Youden Index, with high sensitivity (77%, 95% CI = 74–80%) and specificity (73%, 95% CI = 69–77%). At this threshold, in a second sample of hospital cardiac patients, sensitivity was 93% (95% CI = 76–99%) and specificity was 64% (95% CI = 49–77%). In a final sample generated from a community population, specificity was 100% (95% CI = 85–100%) and sensitivity was 68% (95% CI = 61–74%) at the cut-off of 45.
The SF-36 MCS may be a useful research tool to aid in the classification of cardiac patients according to the presence or absence of depressive symptoms.
KeywordsCoronary heart disease Short-Form 36 mental summary score Centre for Epidemiologic Studies Depression Scale Depression Optimal threshold
Area under the curve
Coronary artery bypass grafting
Coronary artery disease
Centre for Epidemiologic Studies Depression Scale
Coronary heart disease
Health-related quality of life
Hypertension and/or high cholesterol
Identifying depression as a comorbid condition
Negative predictive value
North West Adelaide Health Service
Percutaneous coronary intervention
Positive predictive value
- SF-36 MCS
Short-Form 36 mental summary score
- SF-36 PCS
Short-Form 36 physical summary score
- 6.McDowell, I., & Newell, C. (1996). Measuring health: A guide to rating scales and questionnaires (p. 523). New York: Oxford University Press.Google Scholar
- 8.Attkisson, C. C., & Zich, J. M. (1990). Depression in primary care. National institute of mental health (U.S.), University of California San Francisco. New York: Routledge.Google Scholar
- 16.Ware, J. E., Jr., Kosinski, M., & Keller, S. D. (1994). SF-36 Physical, mental health summary scales: A user’s manual. Boston, Massachusettsd: The Health Institute, New England Medical Center.Google Scholar
- 29.Grant, J. F., et al. (2006) The North West Adelaide Health study: Detailed methods and baseline segmentation of a cohort for selected chronic diseases. Epidemiologic Perspectives Innovations 3(4).Google Scholar
- 30.Grant, J.F., et al. (2008). Cohort profile: The North West Adelaide Health study (NWAHS). International Journal of Epidemiology.Google Scholar
- 34.Ensel, W. (1986) Measuring depression: The CESD scale, in social support, life events and depression. In Lin, N., Dean, A., Ensel, W. M. (Eds.). Academic Press: New York.Google Scholar
- 36.ABS. (2003). Socio-Economic Indexes for Areas, Australia, 2001. Canberra: Australian Bureau of Statistics.Google Scholar