18
Treatment
4.2.2. Mental Health Conditions
COR LOE
Recommendations
2a B-R 1. In patients with CCD, targeted discussions and screening for
mental health is reasonable for clinicians to assess and to refer
for additional mental health evaluation and management.
2a B-R 2. In patients with CCD, treatment for mental health conditions
with either pharmacologic or nonpharmacologic therapies, or
both, is reasonable to improve cardiovascular outcomes.
Table 6. Suggested Screening Tool to Assess Psychological
Distress: Patient Health Questionnaire-2
Depression Screen
Over the past 2 weeks,
how often have you
been bothered by the
following problems? Not at all
Several
days
More than
half the
days
Nearly
every day
Little interest or pleasure
in doing things
0 1 2 3
Feeling down, depressed,
or hopeless
0 1 2 3
Total score of ≥3 warrants further assessment for depression.
Data derived from Kroenke, et al. Med Care. 2003;41:1284-1292 and Levine, et al.
Circulation. 2021;143:e763-e783, Circulation. 2019;140:1363-1365. Reprinted with
permission from Levine GN, et al. Copyright 2021 American Heart Association Inc.
Table 7. Suggested Screening Questions to Assess
Psychological Health
Well-being parameter Question
Health-related optimism How do you think things will go with your health moving
forward?
Positive affect How oen do you experience pleasure or happiness in your
life?
Gratitude Do you ever feel grateful about your health? Do you ever
feel grateful about other things in your life?
Data derived from Levine GN, et al. op. cit. Reprinted with permission from Levine GN, et al.
Copyright 2021 American Heart Association Inc.
