| ORIGINAL ARTICLE |
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| Year : 2017 | Volume
: 1
| Issue : 3 | Page : 102-106 |
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Depression assessment: Spouses are poor proxies for cardiovascular disease patients
Samia R Toukhsati1, Lewis Yau2, Rosemary Yates2, Isabelle Catrice2, Cory Wasser2, Lynette Young2, Kimberley Greening2, Gabriella Flaks2, Jenna Miller2, David L Hare3
1 School of Health & Life Sciences, Federation University Australia, Berwick; Department of Cardiology, Austin Health, Heidelberg; Faculty of Medicine, Dentistry and Health Sciences, Parkville, VIC, Australia
2 Department of Cardiology, Austin Health, Heidelberg, Australia
3 Department of Cardiology, Austin Health, Heidelberg; Faculty of Medicine, Dentistry and Health Sciences, Parkville, VIC, Australia
Correspondence Address:
Dr. Samia R Toukhsati
School of Health & Life Sciences, Federation University Australia, PO Box. 859, Berwick, VIC 3806
Australia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/hm.hm_1_18
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Background: Patients are frequently assisted by proxies, usually a spouse, to complete health and medical surveys, including depression assessments. Objective: The objective of this study was to examine whether spousal assessments of patient depression concord with those of the patient. Materials and Methods: Consecutive adult cardiac patients attending an outpatient cardiovascular disease clinic accompanied by an adult were enrolled. Patient–spousal pairs independently completed the Cardiac Depression Scale (CDS) on behalf of the patient. Proxies provided demographic and medical history information and also completed the Physical Health Questionnaire. Results: A total of 72 patients (males 75%; mean age = 67.18 ± 11.35 years) and 72 spouses (mean age = 65.19 ± 11.49 years) met enrollment and analysis criteria. Most spouses were female (75%). Proxies rated patients significantly higher on the CDS (mean = 93.14 ± 29.33) than did patients of themselves (mean = 87.93 ± 26.79), t(71) = –2.05, P < 0.05. Patient–spousal concordance was low to moderate on the total CDS (concordance correlation coefficient [CCC] = 0.69) and CDS symptoms including mood (CCC = 0.35), anhedonia (CCC = 0.63), anxiety (CCC = 0.71), irritability (CCC = 0.55), hopelessness (CCC = 0.50), cognitive dysfunction (CCC = 0.41), and sleep disturbance (CCC = 0.64). Conclusions: These results suggest that spouses have limited insight into patient's psychological status, as self-reported by patients. Proxy assessments should be interpreted with caution and, wherever possible, patients should be encouraged to complete depression assessments on their own. |
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