title: Depressive symptoms and spiritual wellbeing in asymptomatic heart failure patients.
abstract: Depression adversely predicts prognosis in individuals with symptomatic heart failure. In some clinical populations, spiritual wellness is considered to be a protective factor against depressive symptoms. This study examined associations among depressive symptoms, spiritual wellbeing, sleep, fatigue, functional capacity, and inflammatory biomarkers in 132 men and women with asymptomatic stage B heart failure (age 66.5 years ± 10.5). Approximately 32 % of the patients scored ≥10 on the Beck Depression Inventory, indicating potentially clinically relevant depressive symptoms. Multiple regression analysis predicting fewer depressive symptoms included the following significant variables: a lower inflammatory score comprised of disease-relevant biomarkers (p < 0.02), less fatigue (p < 0.001), better sleep (p < 0.04), and more spiritual wellbeing (p < 0.01) (overall model F = 26.6, p < 0.001, adjusted R square = 0.629). Further analyses indicated that the meaning (p < 0.01) and peace (p < 0.01) subscales, but not the faith (p = 0.332) subscale, of spiritual wellbeing were independently associated with fewer depressive symptoms. Interventions aimed at increasing spiritual wellbeing in patients lives, and specifically meaning and peace, may be a potential treatment target for depressive symptoms asymptomatic heart failure.
authors.affiliation: Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr. #0804, La Jolla, CA, 92093-0804, USA, pmills@ucsd.edu.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Mills
authors.forename: Kathleen
authors.initials: K
authors.lastname: Wilson
authors.forename: Navaid
authors.initials: N
authors.lastname: Iqbal
authors.forename: Fatima
authors.initials: F
authors.lastname: Iqbal
authors.forename: Milagros
authors.initials: M
authors.lastname: Alvarez
authors.forename: Meredith A
authors.initials: MA
authors.lastname: Pung
authors.forename: Katherine
authors.initials: K
authors.lastname: Wachmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Rutledge
authors.forename: Jeanne
authors.initials: J
authors.lastname: Maglione
authors.forename: Sid
authors.initials: S
authors.lastname: Zisook
authors.forename: Joel E
authors.initials: JE
authors.lastname: Dimsdale
authors.forename: Ottar
authors.initials: O
authors.lastname: Lunde
authors.forename: Barry H
authors.initials: BH
authors.lastname: Greenberg
authors.forename: Alan
authors.initials: A
authors.lastname: Maisel
authors.forename: Ajit
authors.initials: A
authors.lastname: Raisinghani
authors.forename: Loki
authors.initials: L
authors.lastname: Natarajan
authors.forename: Shamini
authors.initials: S
authors.lastname: Jain
authors.forename: David J
authors.initials: DJ
authors.lastname: Hufford
authors.forename: Laura
authors.initials: L
authors.lastname: Redwine
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000328:Adult; D000368:Aged; D015415:Biomarkers; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D005221:Fatigue / Q000150:complications; D005260:Female; D006333:Heart Failure / Q000145:classification / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012069:Religion and Psychology; D029181:Spirituality
chemical_list: D015415:Biomarkers