Somatic symptom overlap in beck depression inventory-II scores following myocardial infarction

Background: Depression measures that include somatic symptoms may inflate severity estimates among medically ill patients, including those with cardiovascular disease. Aims: 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. Method: 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. Results: 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. Conclusions: 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.