Depression in patients with heart failure.
BACKGROUND
Psychologic comorbidities, particularly depression, often accompany heart failure and add to the complexity of clinical management. We conducted a study to describe the prevalence of depression, the differences between patients with minimal versus mild to severe depression, and the correlates of depression in patients with heart failure.


RESULTS
Data were collected from 200 patients with symptoms of heart failure resulting from systolic dysfunction. Psychologic assessment included depression, perceived control, neuroticism, educational needs, and social support/network. Patients were, on average, 57.0 (+/-12.1) years old, male (168, 84.0%), and in New York Heart Association (NYHA) class II or III (n=140, 70.0%) with a mean ejection fraction of 25.5+/-6.4%. They had an average maximal oxygen uptake of 15.8 (+/-4.6) mL x kg x min and 6-minute walk distance of 1345.0 (+/-302.1) feet. Minimal depression was described by 105 (52.5%) patients, mild by 62 (31%), moderate by 30 (15%), and severe by 3 (1.5%). The significant differences between patients with minimal depression compared to mild to severe depression were NYHA class (chi2=14.05, P=.003), maximal oxygen uptake (t=2.62, P=.010), 6-minute walk distance (t=4.22, P < .001), beta-blocker therapy (chi2=15.21, P < .001), perceived control (t=7.93, P < .001), and neuroticism (t=-8.85, P < .001).


CONCLUSIONS
More than half the patients studied did not report experiencing significant depression. In those who did, both physical and psychosocial variables accounted for 48.6% of the variance. These findings warrant further research and indicate a need to test interventions aimed at enhancing perceived control, reducing neuroticism, and meeting educational needs to reduce depression in patients with heart failure.
Westlake
Cheryl
C
California State University, Fullerton, California, USA.
Dracup
Kathleen
K
Fonarow
Gregg
G
Hamilton
Michele
M
D000368:Aged; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D015995:Prevalence