Depression and health status in patients with advanced heart failure: a prospective study in tertiary care.
BACKGROUND
Depression impairs health status among patients with coronary disease. The effect of depression on patients with heart failure has been studied to date only in hospitalized patients.


RESULTS
Prospective cohort study of 113 outpatients with advanced heart failure. At baseline, 19% (n = 21) had major depression or dysthymia, 9% (n = 10) had minor depression, and 72% (n = 82) had no current depression diagnosis. Repeated measures analyses of covariance adjusting for demographic and clinical differences demonstrated that the depression groups differed on observed function (6-minute walk distance [F = 4.8, P = .01]), and self-reported generic (SF-36) and disease-specific (Kansas City Cardiomyopathy Questionnaire) health status. Depression groups also differed in severity of self-reported breathlessness, chest pain, and fatigue. Subject- and spouse-reported role function also differed between the groups. Partial correlation (controlling for the same covariates) between baseline Hamilton Depression Scale scores and these outcomes was highly significant at baseline and follow-up.


CONCLUSIONS
Depression is prospectively associated with poorer health status in patients with advanced heart failure. Physical and role function, symptom severity, and quality of life are all significantly affected.
Sullivan
Mark
M
Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle 98195, USA.
Levy
Wayne C
WC
Russo
Joan E
JE
Spertus
John A
JA
D015331:Cohort Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006305:Health Status Indicators; D006333:Heart Failure / Q000150:complications* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies