Screening for depression in patients with myocardial infarction by general practitioners

BACKGROUND: Depression in patients with myocardial infarction (MI) is highly prevalent and associated with increased morbidity and mortality. Routine screening for post-MI depression is recommended. We studied general practitioners' practice of screening for post-MI depression and analysed whether the screening rate varied among subgroups of MI patients with a particular high risk of depression. DESIGN: Population-based cohort study in the Central Denmark Region. METHODS: All patients with a first-time MI in 2009 received a questionnaire 3 months after discharge from hospital. The questionnaire included information on anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS), severity of the disease, and smoking habits. The responders' general practitioners received a questionnaire 1 year after the patient had been discharged from hospital. This questionnaire provided information on screening for depression, comorbidity, and previous mental illness of the patient. Nationwide registers supplied the patients' sociodemographic status the year before the MI. RESULTS: Response rates were 70.5% (908) among patients, and 64.9% (589) among general practitioners. According to the general practitioners, 27.3% (95% CI 23.7-30.9%) MI patients were screened for depression. The screening rate was higher among patients with a history of mental illness (50.0%, p < 0.001), and among patients with anxiety (37.0%, p = 0.002) or depression (37.5%, p = 0.007) as compared with those without these conditions. CONCLUSION: Screening for depression was neither complete among patients with MI or in subgroups of these with a particularly high risk of post-MI depression. More detailed guidelines and initiatives for implementing them may help to optimize general practitioners' screening for post-MI depression.