Sex specificity of resistance to caTAUstrophe.

In Thailand, cardiovascular disease remains in the top five leading causes of death and is strongly associated with premature mortality and disability‐adjusted life years []. Anxiety, depression and stress are common conditions occurring after an acute cardiac event []. A recent systematic review and meta‐analysis estimated the global prevalence of depression at 31.3%, anxiety at 32.9% and stress levels at 57.7% in cardiac patients []. Studies in Thailand have reported one in four patients with acute myocardial infarction experiencing post‐traumatic stress disorder and strong associations with symptoms of anxiety, depression and helplessness [, ]. Acknowledging the multidimensional psychological impact following a cardiac event, Jackson and colleagues proposed the concept of ‘cardiac distress’ and defined it as a persistent negative emotional state that challenges the capacity of a patient to cope with their heart condition, associated treatments and resultant changes to daily living []. Numerous international guidelines and advisories have recommended screening of psychological stressors for those with cardiac conditions for example American Heart Association [], British Association for Cardiovascular Prevention and Rehabilitation [], European Society of Cardiology []. However, psychological distress in cardiac patients is most commonly assessed using a combination of measurement tools including: depression (e.g., Patient Health Questionnaire 9 []; Cardiac Depression Scale []), anxiety (e.g., Generalized Anxiety Disorder 7 []; Cardiac Anxiety Questionnaire []) and stress (e.g., Perceived Stress Scale) []. In contrast, the Cardiac Distress Inventory (CDI) was developed to provide a comprehensive assessment of ‘cardiac distress’ across multiple domains in a single measure []. The CDI measures responses to physical, affective, cognitive, behavioural and social symptoms and experiences related to a patient's cardiac event and recovery []. Development and validation of the CDI in an Australian population ( = 405) confirmed a 55‐item measure with eight subscales that demonstrated good psychometric properties in terms of validity and reliability []. To date, there is no culturally adapted, psychometrically validated measure of cardiac distress for Thai patients. The purpose of this study was to translate the CDI into Thai and evaluate its psychometric properties in a sample of Thai patients with heart disease.