Depression is one of the most
common, curable mental disorders in the world. Health care providers from
various areas see to this illness, including mental health specialists, primary
care clinicians, medical/surgical professionals (Kroenke, 2001).
developing depression after Myocardial Infarction (MI) is a frequent and
serious disease condition, which usually affects 15-30% of post MI patients for
18 months after their cardiac event, (Huffman et al.,
2006). A study shows that post MI depression is related to cardiac
mortality in the space of 6 to 18 months after MI, (Huffman et al., 2006). Moreover,
post MI depression is also related to recurrent cardiac events, reduced quality
of life and social interests.
Cardiovascular disease (CVD) and depression remain the two most common
causes of disability in the developed countries, and expected to become
globally by 2030, WHO, (2013).
Additionally, both of them have a drastic impact on the overall quality
During a consultation with a
post MI patient, it is important to recognize the signs and symptoms of
depression. Some of the them include: low mood and a general uninterest in
socialising ever since the MI. It is important to learn to recognise those
signs and symptoms of depression to allow the individual to get the help they
need as soon as possible.
When a patient arrives in the
clinic, the health professional’s responsibility is to undertake a focused
assessment of their condition. During the assessment, the patient needs to be
informed why the questions are being asked, and their queries are then answered
in plain language. During the length of the consultation, it is important that
the Doctor obtains all of the necessary information for a better patient’s
outcome. Health professionals can also assess the patient by: observing the
patient, using verbal and non- verbal communication and open and closed
One of the assessment tools
that the Doctor can use to identify the severity of depression is the Beck
Depression Inventory II (BDI-II). BDI is a self-rating scale which was created
in 1961 by the American psychiatrist, Aaron Beck, (Bienenfed, 2016). It is the
most frequently used scale worldwide, it was developed based upon symptoms Beck
observed through his career that affected depressed patients. The BDI consists
of 21 items of sensitive, behavioural, and somatic symptoms that take 5-10
minutes to do it.
The Italian Institute of Health guidelines on the assessment of
depression in cardiac patients says that the Cognitive Behavioural Assessment
Hospital Form (CBA-H), is the most frequently used to assess depression which
is very similar to the Hospital Anxiety and Depression Scale (HADS) and the
Beck Depression Inventory (BDI) should be more considered.
Beck Depression Inventory it is designed to measure the severity of the
depression, (Thombs et al 2010). Four new items have been added to the BDI
since was first developed hence be more related to the manual depression
criteria and others, Ceccarini, (2014). Moreover, Beck Depression Inventory-I
form items such as weight loss, change in the body image, work difficulty, and
somatic preoccupation were removed because they were found not to be related to
the overall severity of depression.
The Beck Depression Inventory has been widely studied and consistently had
a positive result. BDI has a very positive impact on the clinical diagnosis for
those suffering from depression. Limitations
of BDI may include the fact that it is a self-reported evaluation, meaning that
not all answers could be entirely true and others hyperbolic, especially in
heart disease patients who are generally more despairing than they would
normally be. As well as this, BDI-II can only measure the severity of
depression in a patient, and cannot be used as a diagnostic tool.
On the other hand, BDI-II can be useful particularly when used with
other assessments of a similar nature, which will provide a more accurate
evaluation of the severity of a patient’s depression. BDI-II can also id
suitable tool to detect depressive disorder in other illness.
A few researches show the BDI-II was more psychometrically excellent measure of depression. Some
of the psychometric measurements are the patient satisfaction, quality of life
According to Heron J (2001)
within the therapists role the professional must rely mostly on the
facilitative interventions, this being so that the service user can determine their
own conclusion without being obligated by the therapist in a prescriptive way
to their preferred outcome, and if the service user comes to their own outcome
by way of their own thoughts and journey then they are more likely to stick to
goals and planned interventions, as it is their own personal goals and not the
preferred goals of the therapist.
To conclude, as evidence shows
that post myocardial infarction patients develop depression hence BDI-II is a
reliable tool to assess the severity of their depression. BDI-II is commonly
used and well supported by past and present literature and is the gold-standard
tool in the hospitalised setting.