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Depression/depressive disorders are commonly encountered psychiatric disorders. There is no data regarding the relationship between this commonly seen situation and heart failure stage/class.
The aim of this study is to evaluate the relationship between various stages of depression/depressive disorders and heart failure stages/classes.
A total of consecutive 419 patients with a mean age of 57.9 ± 14.4 years (age range, 18-96 years) admitted with the symptoms of heart failure and/or with risk factors for heart failure were included in the study. Beck's depression inventory including 21 evaluation sentences was applied to all study participants to measure the level and severity of depression symptoms of persons. Measured total scores were used to grade the severity as minimal (0-10), mild (11-16), moderate (17-29), and severe (30-63).
Two hundred and nineteen patients (52.3%) were male, 247 (58.9%) had hypertension, 139 (33.2%) had diabetes, and 248 cases (59.2%) had coronary heart disease. Stage A heart failure was present in 113 patients (27.0%), stage B in 119 patients (28.4%), stage C in 116 patients (27.7%), and stage D in remaining 71 cases (16.9%). With regard to NYHA classification, 228 patients (54.4%) had class I symptoms, 101 (24.1%) had class II symptoms, 31 (7.4%) had class III symptoms, and class IV symptoms were found in remaining 59 patients (14.1%). The mean left ventricular ejection fraction of all population was 54.2% ± 12.4 and the mean Beck's depression score was 12.4 ± 11.1. It has been found that there was a significant positive relation between both heart failure stage and symptom class and depression score. In addition, with increasing severity of heart failure stage and symptom class the severity of depression increased (table). In univariate regression analysis, heart failure stage, age, marital status, income level, education level, NYHA class, and beta blocker use were risk factors for moderate-severe depression. In multivariate regression analysis, just heart failure stage (OR 4.99 and 95% CI 2.03-12.24, p<0.001) and symptom class (OR 3.06 and 95% CI 1.39- 6.75, p=0.005) were, however, determined as independent variables.
Heart failure stage and symptom class were positively and independently associated with the score and severity of depression.
|Heart failure stage||Stage A||Stage B||Stage C||Stage D||P value for trend|
|Depression score||3.6 ± 4.3||5.3 ± 5.2||19.5 ± 7.9||25.4 ± 9.7||<0.001|
|NYHA class||NYHA I||NYHA II||NYHA III||NYHA IV|
|Depression score||4.4 ± 4.8||18.7 ± 8.1||20.0 ± 8.1||27.4 ± 8.3||<0.001|