title: Depression in atrial fibrillation in the general population.
abstract: BACKGROUND
  Initial evidence suggests that depressive symptoms are more frequent in patients with atrial fibrillation. Data from the general population are limited.
  
  
  RESULTS
  In 10,000 individuals (mean age 56±11 years, 49.4% women) of the population-based Gutenberg Health Study we assessed depression by the Patient Health Questionnaire (PHQ-9) and a history of depression in relation to manifest atrial fibrillation (n = 309 cases). The median (25th/75th percentile) PHQ-9 score of depressive symptoms was 4 (2/6) in atrial fibrillation individuals versus 3 (2/6) individuals without atrial fibrillation, P(X2-Test) = 0.32. Multivariable regression analyses of the severity of depressive symptoms in relation to atrial fibrillation in cardiovascular risk factor adjusted models revealed a relation of PHQ-9 values and atrial fibrillation (odds ratio (OR) 1.04, 95% confidence interval (CI) 1.01-1.08; P = 0.023). The association was stronger for the somatic symptom dimension of depression (OR 1.08, 95% CI 1.02-1.15; P = 0.0085) than for cognitive symptoms (OR 1.05, 95% CI 0.98-1.11; P = 0.15). Results did not change markedly after additional adjustment for heart failure, partnership status or the inflammatory biomarker C-reactive protein. Both, self-reported physical health status, very good/good versus fair/bad, (OR 0.54, 95% CI 0.41-0.70; P<0.001) and mental health status (OR 0.61 (0.46-0.82); P = 0.0012) were associated with atrial fibrillation in multivariable-adjusted models.
  
  
  CONCLUSIONS
  In a population-based sample we observed a higher burden of depressive symptoms driven by somatic symptom dimensions in individuals with atrial fibrillation. Depression was associated with a worse perception of physical or mental health status. Whether screening and treatment of depressive symptoms modulates disease progression and outcome needs to be shown.
authors: Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany.
authors: Renate B
authors: RB
authors: Schnabel
authors: Matthias
authors: M
authors: Michal
authors: Sandra
authors: S
authors: Wilde
authors: Jörg
authors: J
authors: Wiltink
authors: Philipp S
authors: PS
authors: Wild
authors: Christoph R
authors: CR
authors: Sinning
authors: Edith
authors: E
authors: Lubos
authors: Francisco M
authors: FM
authors: Ojeda
authors: Tanja
authors: T
authors: Zeller
authors: Thomas
authors: T
authors: Munzel
authors: Stefan
authors: S
authors: Blankenberg
authors: Manfred E
authors: ME
authors: Beutel
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D002097:C-Reactive Protein / Q000378:metabolism; D003863:Depression / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D002097:C-Reactive Protein