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Relationship between Two Depression Scales and Quality of Life in Patients Undergoing Surgical Coronary Revascularization: A MOTIV-CABG Substudy

Andréa Perrotti, Francesco Monaco, Pierre Vandel, Camille Durst, Fiona Ecarnot and Sidney Chocron

Objective: The MOTIV-CABG trial evaluated the efficacy of antidepressant therapy (Escitalopram) in patients undergoing coronary artery bypass grafting (CABG). Quality of life was assessed using the 36-Item Short Form health survey (SF-36). Depression was assessed using the Beck Depression Inventory short-form (BDI-SF) and the Center for Epidemiological Studies Depression scale (CES-D). We compared the relation between each of these scales, and quality of life.

Methods: We analyzed 1674/1805 questionnaires (93%). Respondents were classified into 4 groups: D+both corresponds to patients classed as depressive by both BDI-SF and CES-D, D-both to patients classed as nondepressive by both BDI-SF and CES-D, D+BDI to patients classed as depressive by BDI-SF and non-depressive by CES-D, D+CES to patients classed as non-depressive by BDI-SF and depressive by CES-D.

Results: The values of Group D+BDI and D+CES were within the range of values of groups D+both and D-both for all SF-36 items. The difference between D+both and D-both was significant for all SF-36 items, including the mental (MCS) and physical component scores (PCS). The PCS was significantly lower in Group D+BDI vs Group D+CES, while the MCS was significantly lower in Group D+CES vs Group D+BDI. There was agreement between BDI and CES-D findings in 1522 questionnaires (83%) and discordance in 318 (17%) (kappa 0.52 (95% CI 0.47-0.57)).

Conclusions: BDI and CES-D are sensitive to different aspects of the effect of depression on quality of life. The integrated use of these scales can be helpful in identifying areas that require specific treatments in patients undergoing CABG