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Depression measures that include somatic symptoms may inflate severity estimates among medically ill patients, including those with cardiovascular disease.
To evaluate whether people receiving in-patient treatment following acute myocardial infarction (AMI) had higher somatic symptom scores on the Beck Depression Inventory–II (BDI–II) than a non-medically ill control group matched on cognitive/affective scores.
Somatic scores on the BDI–II were compared between 209 patients admitted to hospital following an AMI and 209 psychiatry out-patients matched on gender, age and cognitive/affective scores, and between 366 post-AMI patients and 366 undergraduate students matched on gender and cognitive/affective scores.
Somatic symptoms accounted for 44.1% of total BDI–II score for the 209 post-AMI and psychiatry out-patient groups, 52.7% for the 366 post-AMI patients and 46.4% for the students. Post-AMI patients had somatic scores on average 1.1 points higher than the students (P<0.001). Across groups, somatic scores accounted for approximately 70% of low total scores (BDI–II <4) v. approximately 35% in patients with total BDI–II scores of 12 or more.
Our findings contradict assertions that self-report depressive symptom measures inflate severity scores in post-AMI patients. However, the preponderance of somatic symptoms at low score levels across groups suggests that BDI–II scores may include a small amount of somatic symptom variance not necessarily related to depression in post-AMI and non-medically ill respondents.