Validity of the European society of cardiology's psychosocial screening interview in patients with coronary artery disease

The THORESCI study

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective:
The aim of the study was to examine the validity of the European Society of Cardiology (ESC) psychosocial screening instrument.
Methods:
A total of 508 acute (67%) or elective (33%) percutaneous coronary intervention patients (mean [standard deviation]age = 63 [10] years, 81% male) completed the ESC screening interview and established questionnaires for psychosocial risk markers, that is, depression (Patient Health Questionnaire 9), anxiety (Generalized Anxiety Disorder Questionnaire 7), type D personality (Type D Scale 14), hostility (Cook-Medley Hostility Scale 7), and marital/work stress (Maudsley Marital Quality Questionnaire 6, Effort-Reward Imbalance Scale) during or close after hospital admission. At 1-year follow-up, angina and cardiopulmonary symptoms were assessed.
Results:
Prevalence estimates of psychosocial factors based on the ESC screener were as follows: depression (18%), anxiety (33%), negative affectivity (11%), social inhibition (41%), work stress (17%), marital stress (2%), and hostility (38%). Analysis of correspondence with validated questionnaires revealed fair to moderate agreement (depression [κ = .39], anxiety [κ = .23], type D personality [κ = .21]), regardless of percutaneous coronary intervention indication. For work and marital stress, there was poor to fair performance (κ range = .04–.24); agreement for hostility was poor (κ = −.27). A positive ESC screen for depression, anxious tension, and type D personality was associated with more angina and cardiopulmonary symptoms at follow-up (odds ratios ranging between 1.85 (95% confidence interval = 0.84–4.08) and 8.01 (95% confidence interval = 2.35–27.35).
Conclusions:
The ESC screener contributes to the search for a multidimensional and easy-to-use psychosocial screening instrument for cardiac patients. Although the screener, in its current form, may not be sufficiently valid to reliably detect all predefined psychosocial factors, screening scores for depression and anxiety might be useful in clinical practice. Our findings can be used for further refinement and validation of the screener.
Original languageEnglish
Pages (from-to)404-415
JournalPsychosomatic Medicine
Volume79
Issue number4
DOIs
Publication statusPublished - 2017

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Hostility
Interviews
Depression
Confidence Intervals
Odds Ratio
Surveys and Questionnaires

Keywords

  • PSYCHOSOCIAL STRESS
  • Screening
  • Coronary Artery Disease
  • Validation
  • INTERVIEW
  • Depression
  • Anxiety
  • Type D

Cite this

@article{786a41e533ce4cec8bf5ac1b7cb69772,
title = "Validity of the European society of cardiology's psychosocial screening interview in patients with coronary artery disease: The THORESCI study",
abstract = "Objective: The aim of the study was to examine the validity of the European Society of Cardiology (ESC) psychosocial screening instrument.Methods: A total of 508 acute (67{\%}) or elective (33{\%}) percutaneous coronary intervention patients (mean [standard deviation]age = 63 [10] years, 81{\%} male) completed the ESC screening interview and established questionnaires for psychosocial risk markers, that is, depression (Patient Health Questionnaire 9), anxiety (Generalized Anxiety Disorder Questionnaire 7), type D personality (Type D Scale 14), hostility (Cook-Medley Hostility Scale 7), and marital/work stress (Maudsley Marital Quality Questionnaire 6, Effort-Reward Imbalance Scale) during or close after hospital admission. At 1-year follow-up, angina and cardiopulmonary symptoms were assessed.Results: Prevalence estimates of psychosocial factors based on the ESC screener were as follows: depression (18{\%}), anxiety (33{\%}), negative affectivity (11{\%}), social inhibition (41{\%}), work stress (17{\%}), marital stress (2{\%}), and hostility (38{\%}). Analysis of correspondence with validated questionnaires revealed fair to moderate agreement (depression [κ = .39], anxiety [κ = .23], type D personality [κ = .21]), regardless of percutaneous coronary intervention indication. For work and marital stress, there was poor to fair performance (κ range = .04–.24); agreement for hostility was poor (κ = −.27). A positive ESC screen for depression, anxious tension, and type D personality was associated with more angina and cardiopulmonary symptoms at follow-up (odds ratios ranging between 1.85 (95{\%} confidence interval = 0.84–4.08) and 8.01 (95{\%} confidence interval = 2.35–27.35).Conclusions: The ESC screener contributes to the search for a multidimensional and easy-to-use psychosocial screening instrument for cardiac patients. Although the screener, in its current form, may not be sufficiently valid to reliably detect all predefined psychosocial factors, screening scores for depression and anxiety might be useful in clinical practice. Our findings can be used for further refinement and validation of the screener.",
keywords = "PSYCHOSOCIAL STRESS, Screening, Coronary Artery Disease, Validation, INTERVIEW, Depression, Anxiety, Type D",
author = "{van Montfort}, E.M.J. and J. Denollet and J.W.M.G. Widdershoven and N. Kupper",
year = "2017",
doi = "10.1097/PSY.0000000000000433",
language = "English",
volume = "79",
pages = "404--415",
journal = "Psychosomatic Medicine",
issn = "0033-3174",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

Validity of the European society of cardiology's psychosocial screening interview in patients with coronary artery disease : The THORESCI study. / van Montfort, E.M.J.; Denollet, J.; Widdershoven, J.W.M.G.; Kupper, N.

In: Psychosomatic Medicine, Vol. 79, No. 4, 2017, p. 404-415.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Validity of the European society of cardiology's psychosocial screening interview in patients with coronary artery disease

T2 - The THORESCI study

AU - van Montfort, E.M.J.

AU - Denollet, J.

AU - Widdershoven, J.W.M.G.

AU - Kupper, N.

PY - 2017

Y1 - 2017

N2 - Objective: The aim of the study was to examine the validity of the European Society of Cardiology (ESC) psychosocial screening instrument.Methods: A total of 508 acute (67%) or elective (33%) percutaneous coronary intervention patients (mean [standard deviation]age = 63 [10] years, 81% male) completed the ESC screening interview and established questionnaires for psychosocial risk markers, that is, depression (Patient Health Questionnaire 9), anxiety (Generalized Anxiety Disorder Questionnaire 7), type D personality (Type D Scale 14), hostility (Cook-Medley Hostility Scale 7), and marital/work stress (Maudsley Marital Quality Questionnaire 6, Effort-Reward Imbalance Scale) during or close after hospital admission. At 1-year follow-up, angina and cardiopulmonary symptoms were assessed.Results: Prevalence estimates of psychosocial factors based on the ESC screener were as follows: depression (18%), anxiety (33%), negative affectivity (11%), social inhibition (41%), work stress (17%), marital stress (2%), and hostility (38%). Analysis of correspondence with validated questionnaires revealed fair to moderate agreement (depression [κ = .39], anxiety [κ = .23], type D personality [κ = .21]), regardless of percutaneous coronary intervention indication. For work and marital stress, there was poor to fair performance (κ range = .04–.24); agreement for hostility was poor (κ = −.27). A positive ESC screen for depression, anxious tension, and type D personality was associated with more angina and cardiopulmonary symptoms at follow-up (odds ratios ranging between 1.85 (95% confidence interval = 0.84–4.08) and 8.01 (95% confidence interval = 2.35–27.35).Conclusions: The ESC screener contributes to the search for a multidimensional and easy-to-use psychosocial screening instrument for cardiac patients. Although the screener, in its current form, may not be sufficiently valid to reliably detect all predefined psychosocial factors, screening scores for depression and anxiety might be useful in clinical practice. Our findings can be used for further refinement and validation of the screener.

AB - Objective: The aim of the study was to examine the validity of the European Society of Cardiology (ESC) psychosocial screening instrument.Methods: A total of 508 acute (67%) or elective (33%) percutaneous coronary intervention patients (mean [standard deviation]age = 63 [10] years, 81% male) completed the ESC screening interview and established questionnaires for psychosocial risk markers, that is, depression (Patient Health Questionnaire 9), anxiety (Generalized Anxiety Disorder Questionnaire 7), type D personality (Type D Scale 14), hostility (Cook-Medley Hostility Scale 7), and marital/work stress (Maudsley Marital Quality Questionnaire 6, Effort-Reward Imbalance Scale) during or close after hospital admission. At 1-year follow-up, angina and cardiopulmonary symptoms were assessed.Results: Prevalence estimates of psychosocial factors based on the ESC screener were as follows: depression (18%), anxiety (33%), negative affectivity (11%), social inhibition (41%), work stress (17%), marital stress (2%), and hostility (38%). Analysis of correspondence with validated questionnaires revealed fair to moderate agreement (depression [κ = .39], anxiety [κ = .23], type D personality [κ = .21]), regardless of percutaneous coronary intervention indication. For work and marital stress, there was poor to fair performance (κ range = .04–.24); agreement for hostility was poor (κ = −.27). A positive ESC screen for depression, anxious tension, and type D personality was associated with more angina and cardiopulmonary symptoms at follow-up (odds ratios ranging between 1.85 (95% confidence interval = 0.84–4.08) and 8.01 (95% confidence interval = 2.35–27.35).Conclusions: The ESC screener contributes to the search for a multidimensional and easy-to-use psychosocial screening instrument for cardiac patients. Although the screener, in its current form, may not be sufficiently valid to reliably detect all predefined psychosocial factors, screening scores for depression and anxiety might be useful in clinical practice. Our findings can be used for further refinement and validation of the screener.

KW - PSYCHOSOCIAL STRESS

KW - Screening

KW - Coronary Artery Disease

KW - Validation

KW - INTERVIEW

KW - Depression

KW - Anxiety

KW - Type D

U2 - 10.1097/PSY.0000000000000433

DO - 10.1097/PSY.0000000000000433

M3 - Article

VL - 79

SP - 404

EP - 415

JO - Psychosomatic Medicine

JF - Psychosomatic Medicine

SN - 0033-3174

IS - 4

ER -