title: Incidence rates and predictors of major and minor depression in patients with heart failure.
abstract: OBJECTIVE
  Depression is common in heart failure (HF) and associated with adverse outcomes. This study aimed to investigate incidence rates and predictors of depression in patients sampled from four subprojects of the German Competence Network Heart Failure.
  
  
  METHODS
  Eight hundred thirty nine symptomatic HF patients free of depression at baseline underwent repeat depression screening (Patient Health Questionnaire, PHQ-9) after 12 months. Ordered logistic regression analysis was employed to search for predictors of incident depression.
  
  
  RESULTS
  Incident minor (major) depression was observed in 61 (7.3%) and 47 (5.6%) of the population. Depression was recurrent in 15 (25%) and 16 (34%), respectively. Multiple regression analysis revealed seven variables predicting minor or major depression: Previous depressive episode (odds ratio [OR] 4.04, 95% confidence interval [CI] 2.37-6.89, p ≤ 0.001), previous resuscitation (OR 2.44, CI 1.23-4.81, p=0.010), current smoking (OR 2.06, CI 1.08-3.50, p=0.008), >4 visits/year to general practitioner (OR 1.67, CI 1.06-2.63, p=0.026), New York Heart Association class (OR 1.54/class, 95% CI 1.05-2.25, p=0.027), PHQ-9 baseline sum-score (OR 1.18/point, CI 1.11-1.27, p<0.001), and SF-36 physical functioning (OR 1.08/-5 points, CI 1.03-1.13, p=0.002).
  
  
  CONCLUSIONS
  In these HF patients initially free of depression annual incidence rates were high. Several independent predictors allowed identification of patients at particular risk. Although obtained in a selected cohort these findings call, in view of the grave prognosis of HF patients with comorbid depression, for regular depression screening and development of specific supportive strategies to improve patient care and outcomes in HF.
authors.affiliation: University of Heidelberg, Department of Psychosomatic and General Internal Medicine, Heidelberg, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Lossnitzer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Herzog
authors.forename: Stefan
authors.initials: S
authors.lastname: Störk
authors.forename: Beate
authors.initials: B
authors.lastname: Wild
authors.forename: Thomas
authors.initials: T
authors.lastname: Müller-Tasch
authors.forename: Elke
authors.initials: E
authors.lastname: Lehmkuhl
authors.forename: Christian
authors.initials: C
authors.lastname: Zugck
authors.forename: Vera
authors.initials: V
authors.lastname: Regitz-Zagrosek
authors.forename: Sabine
authors.initials: S
authors.lastname: Pankuweit
authors.forename: Bernhard
authors.initials: B
authors.lastname: Maisch
authors.forename: Georg
authors.initials: G
authors.lastname: Ertl
authors.forename: Götz
authors.initials: G
authors.lastname: Gelbrich
authors.forename: Christiane E
authors.initials: CE
authors.lastname: Angermann
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003863:Depression / 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; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires