Abstracts
for WOCP (CI95% 0.13–0.40). When considering the somatization
construct, CCP and NCCP subjects reported similar somatic symptom
complaints, higher than WOCP subjects. Moreover, even if NCCP
subjects showed higher TAS-20 scores than WOCP subjects, these
scores were below the range of a possible alexithymia. As for the
physical health-related QoL (SF-12, subscale PCS-12), regression
analyses showed that the PCS-12 mean score of NCCP was higher
than that of CCP (ß=-2.31; CI95% -4.14 to -0.48) and lower than that
of WOCP (ß=2.24; CI95% 0.12–4.37).
Conclusion: NCCP subjects are characterized from an elevated
anxiety, together with a better physical well-being, when compared
with subjects who have a cardiac failure. The somatization construct
seems less useful to distinguish NCCP from CCP subjects. Conse-
quently, anxiety should be the major target of our mental-health
intervention when treating subjects with chest pain.
doi:10.1016/j.jpsychores.2018.03.019
9 or absence (NOCAD) of obstructive coronary arteries. Psychosocial
Accuracy of the of the PROMIS-57 questionnaire to identify
significant depressive and anxiety symptoms among patients
on hemodialysis
A. Bansala, O. Ekundayoa, A. Xua, S. Lia, E. Tanga, M. Lib,
I. Mucsia, M. Novaka
a
University Health Network, Toronto, Canada, bDepartment of Supportive
Care, Princess Margaret Hospital, Toronto, Canada
Aims: To evaluate the accuracy of the depression and anxiety
domains of the Patient Reported Outcomes Measurement Information
System, 57 item (PROMIS-57) profile questionnaire among hemodi-
alysis patients.
Methods: In a cross-sectional, convenience sample of patients
undergoing hemodialysis, 113 patients completed the PROMIS-57
(includes PROMIS-29), GAD-7 and PHQ-9 questionnaires. Raw scores
of legacy tools were converted to calculated PROMIS T-scores using
PROsetta Stone© crosswalk files. A cut off score of 10 on GAD-7
and PHQ-9 identified clinically significant anxiety or depression,
respectively. Corresponding PROsetta stone cut offs were used to
categorize depression and anxiety on the reported PROMIS-57 scales.
We computed sensitivity, specificity, positive predictive and negative
predictive values. Cohens Kappa was used to assess degree of
agreement between legacy and respective PROMIS domains.
Results: Of 113 participants, mean (SD) age was 50 (17) years, 57%
were male, 42% white. According to legacy instruments, 13% had
moderate to severe anxiety, 27% had depression, while reported
PROMIS-57 scores yielded 14% with anxiety and 15% with depres-
sion. Calculated anxiety scores showed strong correlations with
reported PROMIS-57 (r=0.695, pb0.001) and PROMIS-29 (r=0.611,
pb0.001) scores. Similarly, calculated depression scores showed
strong correlations with reported PROMIS-57 (r=0.627, pb0.001)
and PROMIS-29 (r=0.594, pb0.001) scores. Cut off scores generated
from legacy instruments for moderate-severe anxiety and depression
had high specificity (anxiety=0.93, depression=0.95) and moderate
sensitivity (anxiety=0.60, depression=0.43). Kappa values indicated
moderate agreement between GAD-7 categorization of anxiety
vs PROMIS-57 (K=0.51) and PROMIS-29 (K=0.47); also between
PHQ-9 classification of depression versus PROMIS-57 (K=0.45) and
PROMIS-29 (K=0.41).
Conclusion: The PROMIS-57 depression and anxiety domains are
valid self-report tools to assess depressive and anxiety symptoms
among hemodialysis patients. Further studies are needed to assess if
89
accuracy can be improved by using the computer adaptive testing
PROMIS item banks.
doi:10.1016/j.jpsychores.2018.03.020
10
Ischemia, psychosocial factors, and chest pain in patients referred
for myocardial perfusion scan: Preliminary data from The Heart
Inside Out (THIO) study
M.T. Bekendama, W.J. Kopa, I. Vermeltfoortb, J. de Jongb,
J.W. Widdershovenc, P.M.C. Mommersteega
a
Tilburg University, Tilburg, Noord-Brabant, Netherlands, bDepartment
of Nuclear Medicine, Bernard Verbeeten Institute, Tilburg, Noord-Brabant,
Netherlands, cDepartment of Cardiology, Tweesteden Hospital, Tilburg,
Noord-Brabant, Netherlands
Aims: Chest pain (Angina Pectoris, AP) is a common complaint
in ischemic heart disease (IHD), either in the presence (CAD)
factors and emotions are hypothesized to have a mediating role
in this relationship between coronary obstructions and AP com-
plaints. Preliminary data from the THIO study, concerning patients
with AP and ischemia, are examined for the differences in
psychosocial complaints in the ischemic and non-ischemic group.
During myocardial stress-testing, facial expressions are recorded
and analyzed for emotions using FaceReader facial recognition
software.
Methods: In total 95 patients (mean age 66±9 yr, 50% women)
referred for a myocardial perfusion scintigraphy (MPS) between
January and September 2017 filled out questionnaires on Type D
personality (DS14), depression (PHQ-9), anxiety (GAD-7), and well-
being (MHC-SF). Patients were questioned about physical complaints
during stress testing and emotions were registered using FaceReader
software (N=40).
Results: According to medical records 29 patients (30%) had some
form of ischemia (39% female, 61% male, X2(2)= 3.25, p=.197), of
which severe ischemia was more prevalent in men (9% male, 2%
female, X2(4)=8.35, p=.039). Patients with some form of ischemia
less often reported AP during stress testing (27% versus 41%, X2(1)=
1.86, p=.173), and more often underwent previous coronary
angiography (47% versus 14%, X2(1)=11.98, pb.001). Psychosocial
factors were prevalent in these patients, but no differences were
observed in psychosocial factors between the ischemic and non-
ischemic group (all p'sN.05). Patients with AP during stress testing
more often had lower levels of well-being (19% versus 4%, X2(2)=
10.08, p= .006). FaceReader data show an increase in sadness
(p=.029) and surprise (p=.035) during stress testing. Correlations
between the reported emotions during the stress-testing are fair to
high (.3-.8).
Conclusion: Preliminary analyses show that the ischemic patients
had less AP complaints during MPS stress-testing and that men more
often have severe ischemia. Levels of well-being are lower in the
group with reported AP. FaceReader data show emerging differences
in emotions during stress-testing. Psychosocial impairments are
present, but preliminary analysis showed no association with
ischemia. Medical records are being retrieved and data collection is
on-going.
doi:10.1016/j.jpsychores.2018.03.021