Longitudinal changes in depression screening results in cardiac surgery patients

Abstract

Background: The aim was to investigate longitudinal changes in depression screening results by sex up to one year following cardiac surgery. Methods: We introduced a depression screening project using the Patient Health Questionnaire (PHQ-9) including patients between 2013–2016. Patients received the PHQ-9 prior to surgery, and at follow-up one year after surgery. We analyzed changes in PHQ-9 scores and screening status from baseline to 1-year follow-up. Results: Screening results were obtained in 1,133 patients prior to surgery, and after one year, 1,084 patients were alive and of those 897 (83%) patients completed the follow-up PHQ-9 questionnaire. A positive depression screen at baseline was twice as common in women compared to men. A total of 547 (92%) men and 173 (91%) women who were screening negative at baseline were still screening negative at 1-year follow-up. There was no difference between men and women. A lower proportion of men compared with women (44% vs. 61%) improved from screening positive at baseline to screening negative at 1-year followup (P=0.069). The total PHQ-9 score difference between baseline and one year had increased with 0.23 points among men and decreased with 0.68 points in women. Conclusions: We found that twice as many women as men had a positive depression screen at baseline, and that almost 10% of all who were screening negative at baseline, were screening positive after one year. An improvement in depressive symptoms (transition from a screening positive state to a negative screening state) was more common among women than men after one year of follow up.