Depression and anxiety among coronary heart disease patients: can affect dimensions and theory inform diagnostic disorder-based screening?

P.J. Tully, B.W.J.H. Penninx

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Objectives: To examine the association between low positive affect, somatic anxiety and general distress with affective disorders, anxious misery, and visceral fear among coronary heart disease patients. Participants: Patients awaiting a coronary revascularization procedure (N = 158; 20.9% female; median age = 65, interquartile range 58-73) underwent structured interview with the Mini-International Neuropsychiatric Interview. Patients completed a brief version of the Mood and Anxiety Symptom Questionnaire (i.e., Anxiety Depression Distress Inventory-27) and a measure of Type D personality. Results: Somatic anxiety scores yielded an area under the curve (AUC) = .784 and 75.0% sensitivity and 68.5% specificity in relation to panic disorder. Low positive affect yielded AUC = .811 and 70.4% sensitivity and 77.1% specificity for major depression. General distress yielded AUC = .795 and 75.0% sensitivity and 72.5% specificity for generalized anxiety disorder. No affective dimension was optimally associated with the anxious misery or visceral fear cluster. Trait negative affect was not a suitable screener for any disorder. Conclusions: The Anxiety Depression Distress Inventory-27 dimensions of low positive affect and somatic anxiety provided optimal detection of depression and panic disorder, respectively, as hypothesized, supporting discriminant validity. © 2012 Wiley Periodicals, Inc.
Original languageEnglish
Pages (from-to)448-461
JournalJournal of clinical psychology
Issue number4
Publication statusPublished - 2012

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