Accuracy of anxiety and depression screening tools in heart transplant recipients

Purpose: The aim of this study was to assess the validity and reliability of psychological screening tools in outpatient heart transplant recipients. Methods: Forty-eight heart transplant recipients completed the Patient Health Questionnaire 9-item scale ( PHQ-9 ), Generalized Anxiety Disorder 7-item Scale ( GAD-7 ), Kessler Psychological Distress 10-item Scale ( K-10 ) and Medical Outcomes Short Form 36-item Health Survey. A structured psychological interview ( Mini International Neuropsychiatric Interview Version 6 ) was conducted after completion of the questionnaires. Internal consistency, criterion validity and construct validity of the PHQ-9, GAD-7 and K-10 were evaluated. Results: Internal consistency supported the reliability of the screening tools. The optimal cut-off on the PHQ-9 for depression was 10 ( sensitivity = 0.86; specificity = 0.93 ). A score of 6 on the GAD-7 maximized sensitivity ( 0.75 ) and specificity ( 0.89 ) for anxiety. A score of 17 on the K-10 was the optimal cut-off for diagnosis of either anxiety or depression ( sensitivity = 0.83; specificity = 0.84 ). Increasing scores on the screening tools were associated with lower health-related quality of life. Conclusion: Psychometric analyses support the reliability and validity of the PHQ-9, GAD-7 and K-10 as screening tools for detection of anxiety and depression in heart transplant recipients.