title: Self-care and depression in patients with chronic heart failure.
abstract: 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.
authors.affiliation: Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Holzapfel
authors.forename: Bernd
authors.initials: B
authors.lastname: Löwe
authors.forename: Beate
authors.initials: B
authors.lastname: Wild
authors.forename: Dieter
authors.initials: D
authors.lastname: Schellberg
authors.forename: Christian
authors.initials: C
authors.lastname: Zugck
authors.forename: Andrew
authors.initials: A
authors.lastname: Remppis
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.forename: Markus
authors.initials: M
authors.lastname: Haass
authors.forename: Bernhard
authors.initials: B
authors.lastname: Rauch
authors.forename: Jana
authors.initials: J
authors.lastname: Jünger
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Herzog
authors.forename: Thomas
authors.initials: T
authors.lastname: Müller-Tasch
mesh_terms: 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