Freedland K E, Lustman P J, Carney R M, Hong B A
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63178.
Int J Psychiatry Med. 1992;22(3):221-9. doi: 10.2190/YF10-H39R-NY6M-MT1G.
To determine whether the underdiagnosis of major depression (MD) in patients with coronary artery disease (CAD) may be explained by low specificity and mild severity of depressive symptoms in affected patients.
The Beck Depression Inventory (BDI) was used to assess depression symptoms in thirty-one patients with both CAD and MD, and eighty-three patients with CAD but without MD.
Only ten (48%) of the symptoms were significantly more common in the MD than in the non-MD group, and nine symptoms were present in at least 20 percent of both groups. Of these nine nonspecific symptoms, only one (insomnia) was more severe in the MD patients than in the non-MD group (p < .006). When all twenty-one symptoms were rank ordered by frequency, the most common symptoms in the MD group were also the most common in the non-MD group (r = .91, p < .001).
The symptoms of major depression were found to be relatively mild and nonspecific in patients with CAD. This may help to explain why depression is underdiagnosed in cardiac patients.
确定冠心病（CAD）患者中重度抑郁症（MD）诊断不足是否可归因于患病患者抑郁症状的低特异性和轻度严重程度。
使用贝克抑郁量表（BDI）评估31例同时患有CAD和MD的患者以及83例患有CAD但无MD的患者的抑郁症状。
只有10种（48%）症状在MD组中比非MD组显著更常见，且9种症状在两组中至少20%的患者中出现。在这9种非特异性症状中，只有一种（失眠）在MD患者中比非MD组更严重（p <.006）。当按出现频率对所有21种症状进行排序时，MD组中最常见的症状在非MD组中也是最常见的（r =.91，p <.001）。
发现CAD患者的重度抑郁症症状相对较轻且不具特异性。这可能有助于解释为何心脏病患者中抑郁症诊断不足。
