Self-care and depression in patients with chronic heart failure.
BACKGROUND
Although chronic heart failure (CHF) is often complicated by comorbid depression and poor self-care, little is known about their specific association in patients with CHF.


OBJECTIVE
To investigate self-care behavior among patients with CHF with different degrees of depression severity.


METHODS
A total of 287 patients with documented CHF, New York Heart Association functional class II to IV, completed the European Heart Failure Self-Care Behavior Scale. The Structured Clinical Interview for DSM (SCID) IV served as the criterion standard for the presence of a depressive disorder.


RESULTS
Analyses of covariance and linear regression analyses revealed that patients with CHF with minor depression reported significantly lower levels of self-care than patients with major depression (P = .003) and nondepressed patients (P = .014). In addition to minor depression, age (P < or = .001), multimorbidity (P = .01), left ventricular ejection fraction (P = .001), and family status (P = .01) were determinants of self-care.


CONCLUSIONS
Our results demonstrate that patients with CHF with minor depression and not major depression are at higher risk for poor self-care and its resulting consequences, such as symptom deterioration and frequent hospitalization.
Holzapfel
Nicole
N
Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Germany.
Löwe
Bernd
B
Wild
Beate
B
Schellberg
Dieter
D
Zugck
Christian
C
Remppis
Andrew
A
Katus
Hugo A
HA
Haass
Markus
M
Rauch
Bernhard
B
Jünger
Jana
J
Herzog
Wolfgang
W
Müller-Tasch
Thomas
T
D000223:Adaptation, Psychological; D000368:Aged; D000704:Analysis of Variance; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D011594:Psychometrics; D012307:Risk Factors; D012648:Self Care; D013315:Stress, Psychological; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D016277:Ventricular Function, Left