Emotional distress and fatigue in coronary heart disease: the Global Mood Scale (GMS)

Abstract

SynopsisEvidence indicates that emotional distress has a long-term impact on morbidity and mortality in patients with coronary heart disease (CHD), and that symptoms of depression, fatigue, and reduced energy may identify high-risk patients. This study was designed to: (1) devise a sound and practical measure of emotional distress in CHD patients; (2) examine the relationship between emotional distress and fatigue following CHD; and (3) examine changes in emotional distress as a function of cardiac rehabilitation. A sample of 478 men with CHD (mean age = 57·8±8·7 y) filled out questionnaires 3–6 weeks following a myocardial infarction (N = 110), bypass surgery (N = 302), or coronary angioplasty (N = 66). Statistical analyses of 56 Dutch mood terms were used to produce the 20-item Global Mood Scale (GMS) which measures negative affect (characterized by fatigue and malaise), as well as positive affect (characterized by energy and sociability), in patients with CHD. The GMS was found to be a reliable scale (α > 0·90; r > 0·55 over a 3-month period), and correlations with existing measures of emotional functioning and self-deception indicated its convergent and discriminant validity. Most importantly, fatigue was not related to cardiorespiratory fitness in a subset of 140 patients, but clearly was associated with negative affect. Consistent with the self-efficacy model, scores on the GMS mood scales improved significantly as a function of rehabilitation (P < 0·0001). Although symptoms of emotional distress are easily explained away by situational factors, previous research suggests that failure to recognize the clinical significance of these symptoms in CHD patients may result in the delay of much needed intervention. The current findings suggest that the GMS is a theoretically and psychometrically sound measure of emotional distress in CHD patients, and that this scale is sufficiently sensitive to assess change.

Psychological symptom clusters, psychiatric comorbidity and poor self-reported health status following myocardial infarction

“…The Global Mood Scale (GMS) is a self-report measure assessing both positive (energy and sociability) and negative (fatigue and malaise) mood states in patients with heart disease (22). It consists of 10 positive and 10 negative mood terms answered on a 5-point Likert scale.…”

“…The respondent is asked to rate the extent to which he or she has experienced each mood state lately. The GMS has been shown to be a valid and reliable measure of affective mood states (22,23) and is very responsive to treatment-related changes in mood status (24).…”

“…KMO (0.95) and Bartlett's test of 8,12,18,19;BDI Item 17). The labeling of the components was based on previous literature (22,23). For example, the items included in the Emotional Exhaustion subscale were drawn from the negative affect subscale of the GMS.…”

The Birmingham Rehabilitation Uptake Maximisation Study (BRUM). Home-based compared with hospital-based cardiac rehabilitation in a multi-ethnic population: cost-effectiveness and patient adherence

“…The Short Form with 12 Items (SF-12) 125 and the Global Mood Score (GMS) 126 were also included. The GMS was chosen because it has been shown to be sensitive to change and is able to capture the positive changes resulting from CR (as opposed to the absence of negative changes).…”

Challenges in reducing depression-related mortality in cardiac populations: cognition, emotion, fatigue or personality?

“…Beck Depression Inventory (BDI) scores correlated significantly with scales of the IPQ (which assesses the SRM ), and the IPQ was also able to discriminate between women who were and those who were not depressed. In terms of IPQ subscales, currently depressed women had a stronger depression identity, a more chronic timeline, less perceived control (Meesters & Appels, 1996) BDIÁII (Beck et al, 1996) Center for Epidemiological StudiesDepression scale (CES-D) (Radloff, 1977) Hospital Anxiety and Depression Scale (depression subscale) (Zigmond & Snaith, 1983) Brief-Illness Perception Questionnaire (Broadbent et al, 2006) Global Mood Scale (positive and negative affect rated on a five-point Likert scale) (Denollet, 1993) DS-14 (Type D personality) (Denollet, 2005) (Meesters & Appels, 1996) BDIÁII (Beck et al, 1996) Center for Epidemiological StudiesDepression scale (CES-D) (Radloff, 1977) Hospital Anxiety and Depression Scale (depression subscale) (Zigmond & Snaith, 1983) Brief-Illness Perception Questionnaire (Broadbent et al, 2006) Global Mood Scale (positive and negative affect rated on a five-point Likert scale) (Denollet, 1993) DS-14 (Type D personality) (Denollet, 2005) (Meesters & Appels, 1996) BDIÁII (Beck et al, 1996) Center for Epidemiological StudiesDepression scale (CES-D) (Radloff, 1977) Hospital Anxiety and Depression Scale (depression subscale) (Zigmond & Snaith, 1983) Brief-Illness Perception Questionnaire (Broadbent et al, 2006) Global Mood Scale (positive and negative affect rated on a five-point Likert scale) (Denollet, 1993) DS-14 (Type D personality) (Denollet, 2005) (Meesters & Appels, 1996) BDIÁII (Beck et al, 1996) Center for Epidemiological StudiesDepression scale (CES-D) (Radloff, 1977) Hospital Anxiety and Depression Scale (depression subscale) …”