Validity of Beck Depression Inventory for the assessment of depressive mood in chronic heart failure patients

- Chronic Heart Failure and Depression share overlapping symptoms.
- Validity of French version of BDI is tested by reference to MADRS.
- A strong correlation was found between BDI and MADRS scores.
- The correlation persisted after controlling for potential confounders.
- BDI seems to be a reliable instrument to assess depression in CHF patients.

Prevalence of depression is high in patients with chronic heart failure (CHF), and depressive mood is considered as a risk factor for major cardiovascular events and mortality in CHF patients. The validity of self-administered 21-item Beck Depression Inventory (BDI) in CHF patients might be questioned. CHF actually shares overlapping symptoms with depression and such an overlap may overestimate the impact of depression on cardiac outcomes. We tested the convergent validity of the French version of BDI by reference to the interview-based Montgomery Asberg Depression Rating Scale (MADRS) in a population of 73 patients participating in the multicenter French PANIC Cohort of 321 CHF patients. Both depression scores were associated with NYHA functional class and the number of previous hospitalizations related to CHF, but not with the other indexes of cardiac severity (left ventricular ejection fraction and 6-min-walk test). MADRS scores were also associated with gender and history of depression. A strong correlation was found between BDI and MADRS scores (rho=0.72; p<0.001). This correlation persisted after adjustment for gender, NYHA functional class, number of previous hospitalizations and history of depression (rho=0.68; p<0.001). Moreover, the z score difference between standardized BDI and standardized MADRS scores was associated with none of the sociodemographic or clinical characteristics of our population, except for the depression severity at MADRS. In particular, no overestimation or underestimation of self-assessed depression was found in case of more severe CHF. These findings suggest that the BDI is a reliable instrument to assess depression in CHF patients.