title: Depressive symptom trajectory predicts 1-year health-related quality of life in patients with heart failure.
abstract: BACKGROUND
  One-third of patients with heart failure (HF) experience depressive symptoms that adversely affect health-related quality of life (HRQOL). We aimed to describe depressive symptom trajectory and determine whether a change in depressive symptoms predicts subsequent HRQOL.
  
  
  RESULTS
  The sample consisted of 256 inpatients and outpatients with HF. Depressive symptoms were measured at baseline and 3 or 6 months with the Patient Health Questionnaire (PHQ-9). The Minnesota Living with HF Questionnaire was used to assess HRQOL at baseline, 3 to 6 months, and 1 year. Based on baseline and 3- to 6-month PHQ-9 scores, patients were categorized as depressive symptom-free (64%), depressive symptoms improved (15%), depressive symptoms developed (6%), or persistent depressive symptoms (15%). The groups differed in 1-year HRQOL levels (F = 36, P < .001); patients who were depressive symptom-free or whose depressive symptoms improved had better 1-year HRQOL than patients with persistent depressive symptoms (Tukey honestly significant difference, P < .01). Change in depressive symptoms was the strongest predictor of 1-year HRQOL (standardized β = .42, P < .001), after controlling for functional status, demographics, and clinical variables.
  
  
  CONCLUSIONS
  We found the trajectory of depressive symptoms predicts future HRQOL. Research is needed to determine whether interventions targeting depressive symptoms improve HRQOL in patients with HF.
authors.affiliation: University of Kentucky College of Nursing, Lexington, Kentucky 40536-0232, USA. rdekker@uky.edu
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Dekker
authors.forename: Terry A
authors.initials: TA
authors.lastname: Lennie
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Albert
authors.forename: Mary K
authors.initials: MK
authors.lastname: Rayens
authors.forename: Misook L
authors.initials: ML
authors.lastname: Chung
authors.forename: Jia-Rong
authors.initials: JR
authors.lastname: Wu
authors.forename: Eun Kyeung
authors.initials: EK
authors.lastname: Song
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
mesh_terms: D000368:Aged; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires