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The current issue of EJCN carries a paper by Norris et al. [1], who demonstrate the impact that depression can have on health-related quality of life in a sample of 486 patients with AMI, particularly for women. The results are given added significance given that the authors controlled for various variables measuring disease severity, demographics, socioeconomic status and co-morbidities, but also other interesting variables such as healthy lifestyle, social support and optimistic personality. The authors conclude that negative psychological responses post-AMI affect recovery, and propose that routine screening for depression may form part of a general health assessment for these patients. In a similarly-themed editorial in the EJCN entitled "Depression in cardiac patients: what can nurses do about it?", Thompson and Froelicher [2] also emphasised the importance of depression in cardiac patients and the importance of nurses' roles in caring for these patients. We agree with many of the important points made by these authors, and we would like to expand further on these aspects, with particular reference to research conducted on rapid methods of assessing depression in acute cardiac settings. Furthermore, it is also important to note the limitations of screening without a formal management protocol. Depression is more common in medical patients than in the general population. It has a prevalence of between 15% and 41% in cardiac patients. Depression is not only linked to poorer subjective health and reduced quality of life but is also associated with reduced adherence to medication, reduced participation and increased dropout rates in rehabilitation programmes and reduced adherence to secondary prevention lifestyle changes [3–6]. Both health service use and costs are higher in depressed patients by as much as 40% [3]. The identification of cardiac patients with co-morbid depressive symptoms is therefore crucial for healthcare professionals. The reasons for increased risk in depressed cardiac patients are not fully understood, but proposed

Depression in Cardiac Patients: An Evidence Base for Selection of Brief Screening Instruments by Nursing Staff