Optimal methods for identifying depression following hospitalization for myocardial infarction

Methods for detecting depression were evaluated in 64 men mean age 53 ± 4 yr who underwent treadmill exercise testing 3 and 7 weeks after clinically uncomplicated myocardial infarction. Following an open-ended interview, a therapist rated 9 33 patients as moderately to severely depressed, of whom 3 33 (9%) were judged to require treatment for depression. Two self report scales identified only 2 of the 9 patients with moderate to severe depression and only 1 of the 3 patients requiring treatment. Following a standardized interview, a technician rated 4 of the next 31 patients as moderately to severely depressed, all of whom ( 4 31, 13%) were judged by the therapist to require treatment for depression. Self report identified only 2 of the 4 patients judged by the therapist to require treatment. A trained technician and a therapist detect about the same proportion of patients requiring treatment for depression after myocardial infarction. Both methods of interview are superior to self report scales for the detection of moderately severe depression requiring treatment.