title: Psychopathology and symptoms of atrial fibrillation: implications for therapy.
abstract: BACKGROUND
  Current guidelines recommend that the choice of AF management strategy be guided by the symptomatic status of the patient when in AF. However, little is known regarding what drives AF symptoms. Several limited studies suggest that psychological distress may be linked with AF symptom severity.
  
  
  METHODS
  A total of 300 patients with documented AF completed a questionnaire assessing general health and well-being, including a comprehensive psychological assessment as well as disease-specific measures of AF symptom severity. AF burden was determined by 1-week continuous looping monitor in a subset of patients. Analysis of covariance was used to determine the association between individual measures of depression, anxiety, and somatization disorder symptom severity with measures of general health status and AF-specific symptom severity, adjusting for important confounders.
  
  
  RESULTS
  Patients with worsened severity of depression, anxiety, or somatization disorder symptoms had an associated increase in the severity of symptoms attributed to AF regardless of AF severity scale used (P < 0.0001 for each measure of psychological distress). This association persisted after adjusting for important confounders. Increasing severity of depression and anxiety symptoms were also associated with increased visits to medical care for AF management.
  
  
  CONCLUSIONS
  Our study demonstrates the consequence of psychological distress on AF-specific symptom severity and healthcare resource utilization. Psychological well-being may strongly influence symptom severity and healthcare utilization. An assessment of psychological distress may be an important adjunct to standard AF management that warrants further study, particularly if symptom relief is the primary goal.
authors.affiliation: Department of Medicine, University of North Carolina at Chapel Hill, NC, USA. anilgehi@med.unc.edu
authors.forename: Anil K
authors.initials: AK
authors.lastname: Gehi
authors.forename: Samuel
authors.initials: S
authors.lastname: Sears
authors.forename: Neeta
authors.initials: N
authors.lastname: Goli
authors.forename: T Jennifer
authors.initials: TJ
authors.lastname: Walker
authors.forename: Eugene
authors.initials: E
authors.lastname: Chung
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schwartz
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Wood
authors.forename: Kimberly
authors.initials: K
authors.lastname: Guise
authors.forename: J Paul
authors.initials: JP
authors.lastname: Mounsey
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000453:epidemiology / Q000523:psychology; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires