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Rehabilitation Measures

Cardiac Depression Scale

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Purpose

The CDS measures depression in adult cardiac patients.

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Instrument Details

Acronym CDS

Area of Assessment

Depression

Administration Mode

Paper & Pencil

Cost

Free

Key Descriptions

  • A self-report 26-item, seven-point Likert-type scale ranging from strongly disagree (1) to strongly agree (7).
  • Minimum score of 26 and maximum score of 182.
  • Items 2, 4, 12, 15, 19, 20, and 23 are reversed scored:
    1 = 7
    2 = 6
    3 = 5
    4 = 4
    5 = 3
    6 = 2
    7 = 1
  • A total higher score reflects more severe depressive symptoms.

Number of Items

26

Equipment Required

  • CDS Form
  • Pen/Pencil

Time to Administer

5 minutes

Required Training

No Training

Instrument Reviewers

Initially reviewed by Kristine Flais in November 2013.

Considerations

The Cardiac Depression Scale is under copyright. Further information can be obtained from Dr. Samia Toukhsati at samia.toukhsati@austing.org.au or Professor David Hare at david.hare@austin.org.au.

  • The test indexes the full spectrum of depressive symptoms in adult cardiac disease patients.
  • The test has excellent reliability, sensitivity and specificity properties.
  • The test is easy to administer and no special training is necessary.
  • A copy of the test is not readily available which may make it difficult to utilize.
  • No standard error of measurement or normative data is available.

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Cardiovascular Disease

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Cut-Off Scores

Adult cardiac patients:

(Shi et al, 2010; n = 215)

  • A cut off score of > 95 had 97% sensitivity and 85% specificity for major depression as indexed using the Mini-International Neuropsychiatric Interview

(Wise et al, 2006; n = 627; mean age= 58.7 (13.0))

  • Score >100 indicates severe depression with 88% sensitivity and 84% specificity
  • Score of 90 indicates mild to moderate depression with 84% sensitivity and 78% specificity

Test/Retest Reliability

Adult cardiac patients:

(Birks et al, 2004; n = 396; mean age= 67(9))

  • Excellent test-retest reliability (r = 0.79)

Internal Consistency

Adult cardiac patients:

(Birks et al, 2004)

  • Excellent internal consistency (Cronbach’s alpha = 0.93)

(Hare and Davis, 1996; n = 246; mean age= 59.3 (14.1))

  • Excellent internal consistency (Cronbach’s alpha = 0.90)

(King et al, 2009; n = 120; mean age = 63.54 (10.16); mean post-operative days 6.58 (3.53); status-post first time coronary artery bypass graft surgery data collected at hospital discharge, 6, 12, and 36 weeks post-operatively; males only)

  • Excellent internal consistency (Cronbach’s alpha = 0.86 - 0.91)

(Kiropoulos et al, 2012; n = 152; mean age = 70.34 (8.18); 3.5 months after cardiac hospitalization)

  • Excellent internal consistency (Cronbach’s alpha = 0.91)

(Wise et al, 2006)

  • Excellent internal consistency (Cronbach’s alpha = 0.92)

Criterion Validity (Predictive/Concurrent)

Adult cardiac patients:

(Benedetto et al, 2006; n = 81; mean age=57 (12); 2 weeks post acute coronary syndrome)

  • Excellent correlation with Beck Depression Inventory-II (r = 0.69)

(Birks et al, 2004)

  • Excellent correlation with Beck Depression Inventory (r = 0.78)
    • Excellent correlation with anxiety and depression subscales of the Hospital Anxiety and Depression Scale (r = 0.751 and r = 0.770, respectively)

(Hare and Davis, 1996)

  • Excellent correlation with Beck Depression Inventory (r = 0.73)

(King et al, 2009)

  • Excellent correlation with Beck Depression Inventory (r = 0.751, 0.787, 0.737, 0.819) at baseline, 6, 12, and 36 weeks respectively

(Kiropoulos et al, 2012)

  • Excellent correlation with Beck Depression Inventory-II (r = 0.65)
    • Excellent correlation with State Trait Anxiety Inventory (r = 0.61)

    (Wise et al, 2006)

    • Excellent correlation with Geriatric Depression Scale-Short From (r = 0.77)

Bibliography

Birks, Y., Roebuck, A., et al. (2004). "A validation study of the Cardiac Depression Scale (CDS) in a UK population." Br J Health Psychol 9(Pt 1): 15-24.

Di Benedetto, M., Lindner, H., et al. (2006). "Depression following acute coronary syndromes: a comparison between the Cardiac Depression Scale and the Beck Depression Inventory II." Journal of psychosomatic research 60(1): 13-20.

Hare, D. L. and Davis, C. R. (1996). "Cardiac Depression Scale: validation of a new depression scale for cardiac patients." J Psychosom Res 40(4): 379-386.

King, K. M., Colella, T. J., et al. (2009). "Using the cardiac depression scale in men recovering from coronary artery bypass surgery." Journal of clinical nursing 18(11): 1617-1624.

Kiropoulos, L. A., Meredith, I., et al. (2012). "Psychometric properties of the cardiac depression scale in patients with coronary heart disease." BMC Psychiatry 12(1): 216.

Shi, W. Y., Stewart, A. G., et al. (2010). "Major depression in cardiac patients is accurately assessed using the Cardiac Depression Scale." Psychotherapy and psychosomatics 79(6): 391-392.

Wise, F. M., Harris, D. W., et al. (2006). "Validation of the Cardiac Depression Scale in a cardiac rehabilitation population." J Psychosom Res 60(2): 177-183.