title: Depression in paroxysmal and persistent atrial fibrillation patients: a cross-sectional comparison of patients enroled in two large clinical trials.
abstract: OBJECTIVE
  Despite its high clinical relevance, few studies have investigated depression in patients with atrial fibrillation (AF). We aimed to assess whether depressed mood was more common in persistent or paroxysmal AF patients in controlled models and report frequencies of major depressive disorder.
  
  
  RESULTS
  Cross-sectional data from two contemporary clinical trials were used to compare paroxysmal (n = 310) and persistent (n = 392) AF patients' depressed mood severity (measured by the Major Depression Inventory) with each trial including only one patient type. A four-category outcome of depressed mood severity was chosen as exposure variable. Ordinal logistic regression was applied to analyse the association of AF type with depressed mood in a crude model and a confounder control model. In the study sample, 8.4% were classified as having major depressive disorder [10.5% of persistent and 5.8% of paroxysmal patients; odds ratio (OR) = 1.89; 95% confidence interval (CI): 1.07-3.37], according to the diagnostic and statistical manual of mental disorders [(diagnostic and statistical manual of mental disorders (DSM-IV)] criteria. In both the age and sex adjusted crude model and in the confounder control model, the association of persistent AF with more severe depressed mood was significant (OR confounder controlled model = 1.44; 95% CI: 1.13-1.75, P = 0.007).
  
  
  CONCLUSIONS
  Persistent AF patients may suffer from more severe depressed mood than paroxysmal AF patients with similar symptom burden after controlling for relevant factors.
authors.affiliation: Institute of Epidemiology II, Working Group Mental Health, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85758 Neuherberg, Germany.
authors.forename: Alexander F
authors.initials: AF
authors.lastname: von Eisenhart Rothe
authors.affiliation: Department of Cardiology and Intensive Care, St Vincenz Hospital Paderborn, 33098 Paderborn, Germany Working Group Molecular Electrophysiology, University Hospital Magdeburg, Magdeburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Goette
authors.affiliation: University of Birmingham Center for Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK Department of Cardiology and Angiology, Universitätsklinikum Münster, 85758 Münster, Germany.
authors.forename: Paulus
authors.initials: P
authors.lastname: Kirchhof
authors.affiliation: Department of Cardiovascular Medicine, Hospital of the University of Münster, Münster, Germany.
authors.forename: Günter
authors.initials: G
authors.lastname: Breithardt
authors.affiliation: Institut für Herzinfarktforschung Ludwigshafen, 67063 Ludwigshafen, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Limbourg
authors.affiliation: School of Health and Population Sciences, University of Birmingham, Birmingham B15 2TT, UK.
authors.forename: Melanie
authors.initials: M
authors.lastname: Calvert
authors.affiliation: Institute of Epidemiology II, Working Group Mental Health, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85758 Neuherberg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Baumert
authors.affiliation: Institute of Epidemiology II, Working Group Mental Health, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85758 Neuherberg, Germany Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, 85758 Munich, Germany ladwig@helmholtz-muenchen.de.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Ladwig
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D015984:Causality; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D019317:Evidence-Based Medicine; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Atrial fibrillation; Depression; Mental health; Prevalence