The Hospital Anxiety and Depression Scale depression subscale, but not the Beck Depression Inventory-Fast Scale, identifies patients with acute coronary syndrome at elevated risk of 1-year mortality.

OBJECTIVE The objective of this study was to investigate the use of short-form depression scales in assessing 1-year mortality risk in a national sample of patients with acute coronary syndrome (ACS). METHODS Patients with ACS (N=598) completed either the Hospital Anxiety and Depression Scale depression subscale (HADS-D) or the Beck Depression Inventory-Fast Scale (BDI-FS). Their mortality status was assessed at 1 year. RESULTS Cox proportional hazards modeling showed that patients depressed at baseline (combining HADS-D and BDI-FS depressed cases) were more likely to die within 1 year [hazard ratio (HR)=2.8, 95% CI=1.4-5.7, P=.005], even when controlling for major medical and demographic variables (HR=4.1, 95% CI=1.6-10.3, P=.003). Scoring above the threshold on the HADS-D predicted mortality (HR=4.2, 95% CI=1.8-10.0, P=.001), but scoring above the threshold on the BDI-FS did not (HR=1.8, 95% CI=0.6-5.6, P=.291). CONCLUSION The HADS-D predicted increased risk of 1-year mortality in patients with ACS.