Relationship of depression, anxiety, and social isolation to chronic heart failure outpatient mortality

Friedmann, Erika; Thomas, Sue; Liu, Fang; Morton, Patricia Gonce; Chapa, Deborah W.; Gottlieb, Stephen S.

doi:10.1016/j.ahj.2006.05.009

Cited by 266 publications

(164 citation statements)

References 30 publications

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Section: Introductionmentioning

confidence: 98%

“…Reported rates have ranged from 20% for diagnostic clinical interview criteria to approximately 45% for symptoms measured with a self-report questionnaire (Haworth et al, 2005;Friedmann et al, 2006). Despite these high prevalence rates, few studies have examined how anxiety affects the progression of heart failure (Clarke et al, 2000;Cully et al, 2009;Friedmann et al, 2006;Tsuchihashi-Makaya et al, 2009). The available studies have described an association between higher anxiety and more limitations in activities of daily living (Clarke et al, 2000), poorer physical quality of life (Volz et al, 2011), greater impairment in functional status (Friedmann et al, 2006), higher medical service use (Cully et al, 2009), and more re-hospitalizations (Tsuchihashi-Makaya et al, 2009;Volz et al, 2011) in patients with chronic heart failure.…”

Section: Introductionmentioning

confidence: 99%

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Avoidant coping moderates the association between anxiety and patient-rated physical functioning in heart failure patients

et al. 2011

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Previous research has indicated that anxiety may be associated with adverse health outcomes in heart failure patients. Little research, however, has explored whether anxiety interacts with patients' coping strategies in their associations with physical functioning. The present study examined whether coping strategies moderated the association between anxiety and self-rated physical functioning in 273 heart failure patients. Hierarchical multiple regression analysis, adjusting for demographic and medical covariates, indicated that both anxiety (b=1.15, β=0.46, P<0.001) and avoidant coping (b=0.43, β=0.16, P<0.01) were significantly associated with poorer physical functioning in separate models. Results also demonstrated a significant interaction between avoidant coping and anxiety (b=0.56, β=0.14, P<0.01), such that the association between anxiety and poorer physical functioning was stronger for patients who frequently used avoidant coping strategies than for those who avoided less frequently. Approach coping, however, was not directly associated with physical functioning, nor did it moderate the association between anxiety and physical functioning. The findings suggest that anxious heart failure patients who engage in avoidant coping may be at particular risk for physical dysfunction.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Avoidant coping moderates the association between anxiety and patient-rated physical functioning in heart failure patients

et al. 2011

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“…Moreover, positive feedback has been demonstrated to exist between HF and depression. Previous studies reported that depression may worsen HF symptoms and thus contribute to a poorer prognosis in this population, resulting in a 2- to 3-fold increase in mortality [5,6,7,8,9]. However, there are no available data concerning the effectiveness and impact of depression treatment on long-term prognosis in patients with severe HF who were implanted with cardiac resynchronization pacemakers with a defibrillator (CRT-D).…”

Section: Objectivesmentioning

confidence: 91%

The Incidence, Clinical Significance, and Treatment Effects of Depression in Cardiac Resynchronization Therapy Recipients

et al. 2017

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Objectives: Chronic heart failure (HF) is associated with significantly increased prevalence of depression. The aim of the study was to assess the incidence and clinical impact of depression as well as the effectiveness of depression treatment in HF patients. Methods: A prospective interventional trial included 285 consecutive cardiac resynchronization therapy recipients. Patients underwent a psychiatric examination at the time of implantation and then it was routinely repeated at 3, 6, and 12 months after the procedure, and every 6 months thereafter. One hundred and thirty-five (47.4%) patients with depression were included in the depression group, whereas the control group was comprised of 150 patients free of depression. Sixty-eight (50.4%) subjects received antidepressants (treated group), whereas the observational group had 67 (49.6%) depressed patients who refused to take antidepressants. Results: Depression remission was achieved in 51 (75.0%) patients from the treated group. Long-term mortality and HF hospitalization rates were significantly higher in the depression group than in the control group (20.7 vs. 11.3% and 32.6 vs. 19.2%, respectively). However, remission from depression was associated with a 40% reduction in the relative risk of major adverse cardiac events (MACE). Conclusions: Patients with HF and concomitant depression are at higher risk of MACE compared with those free of depression. Effective antidepressant treatment may significantly improve long-term outcomes in this population.

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“…Nach einer Metaanalyse auf der Basis von 8 Studien beträgt das relative Risiko 2,1 (95%-Konfidenzintervall 1,7-2,6; [31]). Kürzlich erschienene Studien bestätigen an größe-ren Patientenkollektiven diese Risikoerhöhung [13,18,34].…”

Section: Depression Als Prognostischer Faktorunclassified

Depression bei Herzinsuffizienz

Faller

Angermann

2008

Internist

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A major depressive episode is diagnosed based on several well-defined criteria as the presence of depressed mood and loss of interest. According to a large meta-analysis the prevalence of major depression in patients with chronic heart failure is more than 20%. Etiological factors include individual (genetic) disposition and social environment as well as psychosocial stress and biological risk factors related to the chronic cardiac illness. As in coronary artery disease, mortality rates are increased in patients suffering from heart failure and comorbid depression. Possible mechanisms mediating this relationship include both biological (e.g. severity of chronic heart failure, autonomic and immunological dysregulation, multiple comorbidities) and behavioral factors (health behavior, compliance with pharmacological and non-pharmacological therapy). Shared pathophysiological mechanisms as well as a common genetic disposition are also discussed. Simple screening instruments and effective treatment options (psychotherapy, selective serotonin re-uptake inhibitors) are available. However, at present evidence is lacking that beyond improvement of depression these strategies impact favorably on morbidity and mortality.

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Relationship of depression, anxiety, and social isolation to chronic heart failure outpatient mortality

Cited by 266 publications

References 30 publications

Avoidant coping moderates the association between anxiety and patient-rated physical functioning in heart failure patients

Avoidant coping moderates the association between anxiety and patient-rated physical functioning in heart failure patients

The Incidence, Clinical Significance, and Treatment Effects of Depression in Cardiac Resynchronization Therapy Recipients

Depression bei Herzinsuffizienz

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