title: [Psychosocial co-symptoms in primary care patients with heart failure].
abstract: OBJECTIVE
  Psychosocial distress is a common phenomenon in patients with heart failure (HF). The aim of this study was to analyze psychosocial co-symptoms and their relationship with clinical and sociodemographic factors.
  
  
  METHODS
  In 363 primary care patients with HF, anxiety, depression and negative affectivity (HADS, DS-14), disease coping (FKV) and social support (F-SozU) were measured by validated questionnaires. Severity of HF (according to NYHA classification and Goldman's Specific Activity Scale) and sociodemographic characteristics were documented by self-report instruments.
  
  
  RESULTS
  Increased anxiety and/or depression was found in 29.2% of patients. Anxiety and depression scores were significantly higher than in the German general population (p < 0.005). They were furthermore associated with NYHA and Goldman class (anxiety: p = 0.001; depression: p = 0.001). One third of the sample showed the type D personality pattern, which has been associated with increased mortality in cardiac patients. While HF severity correlated positively with psychological distress, patients living together with other persons had lower HF class than those living alone. Using regression analysis, sociodemographic and psychological variables predicted perceived severity of HF in 20.3% if measured by Goldman's scale (significant for sex, age, depressive symptoms and disease coping), and in 18.6% if measured by NYHA (significant for anxiety).
  
  
  CONCLUSIONS
  Severity of HF symptoms and psychosocial factors are interrelated. Self-reported severity of HF is substantially influenced by demographic and psychological variables. In this, it is not relevant if severity is measured by a nonvalidated (NYHA) or a validated instrument (Goldman).
  
  
  CONCLUSIONS
  In primary care patients with HF, psychosocial co-symptoms are frequent and interfere with perceived severity of disease. Psychological distress should be considered important in diagnostics and treatment, especially in patients living alone.
authors.affiliation: Abteilung Allgemeinmedizin, Universität Göttingen, Göttingen. mschere@gwdg.de
authors.forename: Martin
authors.initials: M
authors.lastname: Scherer
authors.forename: Beate
authors.initials: B
authors.lastname: Stanske
authors.forename: Dirk
authors.initials: D
authors.lastname: Wetzel
authors.forename: Janka
authors.initials: J
authors.lastname: Koschack
authors.forename: Michael M
authors.initials: MM
authors.lastname: Kochen
authors.forename: Christoph
authors.initials: C
authors.lastname: Herrmann-Lingen
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001007:Anxiety; D003863:Depression / Q000209:etiology; D005260:Female; D006333:Heart Failure / Q000145:classification / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality; D011320:Primary Health Care; D011788:Quality of Life / Q000523:psychology; D012044:Regression Analysis; D012737:Sex Factors; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires