Depression in patients with heart failure

Abstract

INTRODUCTION: Heart failure (HF) is a chronic progressive syndrome, which is a result of preceding heart diseases and manifests with serious symptoms. Depression and anxiety are frequent comorbidities in chronic HF, which deteriorate the general status of the patients and are related to unfavorable health results—increased number of hospitalizations, deteriorated quality of life, and elevated mortality. AIM: The aim of this article is to assess the tendency to fall into depression of patients with HF in NYHA class III-IV, hospitalized in the non-invasive cardiology clinic of St. Marina University Hospital, Varna and the link to socioeconomic factors—social isolation, family status, educational level, region of residence and so on. MATERIALS AND METHODS: Overall, 39 patients with HF (17 women and 22 men) were investigated. They were in III-IV NYHA functional class during hospitalization. After preliminarily informed consent, they were asked to fill out a validated screening questionnaire for depression in adults—the 15-item Geriatric Depression Scale (GDS). The link to the patients’ socioeconomic, demographic, biological, and clinical characteristics was sought with the help of a multi-factor linear and logistic regression analysis. RESULTS: The results for the level of depression among HF patients were related to socioeconomic factors— region of residence, level of education, social isolation as well as to other variables—gender, age, and systolic left ventricular function assessed through the ejection fraction (EF). Higher levels of depression were observed in patients who resided in larger populated areas, with higher level of education and patients living alone. As far as gender was concerned, females were more susceptible to depressive episodes than males. At an average EF of 49.54 ±15.29%, the decreased left ventricular systolic function was also a factor of the degree of development of anxiety and depression. In a multi-factor analysis, however, only living alone was related to enhanced depressive attitude. CONCLUSION: Depression/anxiety in HF patients requires increased need of health care, shows poor health results, has high costs for treatment related to the serious symptoms, disability and high mortality. Regardless of that, no programs for timely detection, diagnosis, and treatment have been developed yet.