Patient Perception Key Factor for Depression in Heart Failure

Depression score more related to functional, subjective indexes in patients with heart failure
By Eric Metcalf
HealthDay Reporter

MONDAY, May 11 (HealthDay News) -- Depression in heart failure patients appears to be more related to patients' perceptions of disease severity than objective measurements of severity, according to research published in the May 1 issue of the American Journal of Cardiology.

Stephen S. Gottlieb, M.D., of the University of Maryland in Baltimore, and colleagues analyzed data from 2,322 participants in the Heart Failure-ACTION study of aerobic exercise in patients with systolic heart failure. Patients underwent testing for depression with the Beck Depression Inventory (BDI), and objective markers of heart failure severity (such as ejection fraction) and subjective markers (like six-minute walk) were assessed.

Depression, based on increased BDI score, was seen in 43 percent of patients. Elevated BDI score was highly associated with subjective measurements of functional status, including reduced quality of life, but depression was only minimally related to objective measurements of heart failure severity.

"The present study suggested that physicians might improve heart failure symptoms (e.g., indicated using quality-of-life instruments) by addressing depression. Clinicians should evaluate a patient's psychological status and take into account changes in a person's life and environment when increased symptoms are reported. Worsening depression could lead to overestimation of severity of disease," the authors conclude. "Although objective measurements also have limitations, with hemodynamic parameters and ejection fraction not reliably predictive of outcome or symptoms, they must be used in the careful evaluation of patients."

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