Differences between depressed patients with heart failure and those with pulmonary disease.
OBJECTIVE
The objective of this study was to examine differences between depressed medical inpatients with congestive heart failure (CHF) and chronic pulmonary disease (CPD) that could impact the etiology and management of depression in this setting.


METHODS
Patients aged 50 years or over consecutively admitted to Duke University Medical Center and three community hospitals were screened for depressive disorder using the Structured Clinical Interview for Depression (SCID-IV). Characteristics of depressed patients with CHF (N = 174) and CPD (N = 527) were compared. Analyses were stratified by type of depressive disorder (major versus minor).


RESULTS
Depressed hospitalized medical patients with CHF and CPD are similar to one another in many respects, particularly with regard to severity of depressive symptoms and shortness of breath. However, patients with CHF in this study had greater medical comorbidity and overall more severe medical illnesses but less severe CHF-specific disease severity compared with patients with CPD. Patients with CPD, however, were more likely to have psychologic risk factors such as a psychiatric history, comorbid psychiatric illness, and stressful life events.


CONCLUSIONS
These findings suggest important differences between depressed patients with CHF and those with CPD, perhaps reflecting differences in depression etiology and need for specific strategies for managing depression in each of these conditions.
Koenig
Harold G
HG
Department of Psychiatry, Duke University Medical Center, GRECC VA Medical Center, Durham, NC 27710, USA. koenig@geri.duke.edu
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015984:Causality; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D010343:Patient Admission; D010552:Personality Assessment; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D012307:Risk Factors; D013223:Statistics as Topic