Prevalence and predictors of anxiety and depression in a sample of chronic heart failure patients with left ventricular systolic dysfunction

Abstract

Objective: To determine the prevalence and predictors of anxiety and depression in patients with heart failure due to Left Ventricular Systolic Dysfunction (LVSD). Background: Psychological adjustment to Chronic Heart Failure (CHF) can be poor, with the prevalence of depression in out-patients ranging from 13% to 48%. The prevalence of anxiety disorders in this population is unknown and the factors that predict anxiety and depression are not well understood. Methods: 100 out-patients from a community heart failure programme completed a clinical diagnostic interview-the Structured Clinical Interview (SCID-I), to evaluate anxiety and depression. Mean age was 67 T 11 years, 17% were women and 91% were NYHA Class II or III. Other standardised measures were of cognition, biomedical status, social support and previous physical and mental health history. Results: The prevalence rates of anxiety and depression (all subtypes) were 18.4% and 28.6%, respectively. Predictors of depression included a reported history of mental ill-health and NYHA class. Predictors of anxiety included a reported history of mental ill-health, comorbid physical illness (diabetes and angina) and NYHA class. Severity of LVSD did not predict either anxiety or depression. Conclusions: Both anxiety and depression are common in CHF patients. The data on the predictors of poor psychological adjustment might assist in targeting bio-psychosocial intervention for patients who are at most at risk of anxiety and depression, within community CHF disease management programmes.

Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

“…Most depressed patients are fatigued though not all fatigued patients are depressed (Tiesinga et al, 1996). Anxiety is associated with the severity of CHF and chest pain (Friedmann et al, 2006;Haworth et al, 2005) but to what extent anxiety is related to fatigue has not been investigated. However, because fatigue is a substantially complex phenomenon a more detailed exploration of the relationship between emotional distress and fatigue experiences and its manifestations is needed.…”

Fatigue in Patients with Chronic Heart Failure — A Burden Associated with Emotional and Symptom Distress

“…Depression is associated with exacerbated physical symptoms, such as fatigue and breathlessness [8][9][10]. Several studies have shown that approximately one third of the patients with CHF suffer from depressive symptoms and that depression predicts worsening health status and general decline in daily living and well-being [11][12][13]. Moreover, depression is a good predictor of high mortality [14,15].…”

“…Although anxiety seems to be strongly related to depression in patients with CHF, no evidence of a relationship between anxiety and poor prognosis of CHF has been found [16]. Impaired functional status, as measured with New York Heart Association (NYHA) functional classification system [17], chest pain (angina) and co-morbidity were associated with anxiety [10,12] but to what extent anxiety is related to fatigue has not been investigated. Fatigue and depression seem to be inherently associated with each other.…”

Anxiety and Poor Social Support are Independently Associated With Adverse Outcomes in Patients With Mild Heart Failure

“…12,15 Importantly, those reports studied selected patients with HF, such as hospitalized patients, 10,12 and those with low ejection fraction (EF <35%). 16,17 Therefore, the impact of depression, as well as anxiety, on the outcomes of stable outpatients with mild (New York Heart Association (NYHA) functional class I or II) HF has not been evaluated in the "real world" clinical practice. Moreover, the contribution of psychosocial factors to the presence of anxiety has not been studied in HF patients.…”