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Depression, physical impairment, and treatment of depression in chronic heart failure

Carolyn L Turvey1, Dawn M Klein, Carla J Pies

  • 1Department of Psychiatry, University of Iowa, Iowa City, Iowa 52242-1000, USA. Carolyn-Turvey@uiowa.edu

The Journal of Cardiovascular Nursing
|May 16, 2006
PubMed

Insights

Patient attitudes toward impairment significantly influence depression in heart failure patients. Addressing emotional adjustment to physical limitations is key for managing chronic depressive symptoms.

Area of Science:

  • Cardiology
  • Psychiatry
  • Rehabilitation Medicine

Background:

  • Heart failure (HF) is frequently comorbid with depression.
  • Depression in HF patients is linked to physical impairment.
  • The role of patient attitudes in this relationship requires further investigation.

Purpose of the Study:

  • To examine how attitudes about impairment mediate the link between depression and physical impairment in heart failure patients.
  • To assess the current use of antidepressant treatments in outpatients with heart failure.

Main Methods:

  • 32 depressed and 51 non-depressed heart failure outpatients were enrolled.
  • Baseline assessments included medical, functional, cognitive, and psychological measures.
  • Depression was reassessed in the depressed cohort at 8, 16, and 24 weeks.

Main Results:

  • Attitudes about impairment and social support were strong correlates of depression.
  • The association between physical impairment and depression diminished when attitudes about impairment were controlled.
  • Attitudes about impairment predicted the persistence of depressive symptoms over time.

Conclusions:

  • The relationship between physical impairment and depression in heart failure is moderated by patients' coping mechanisms and attitudes.
  • Interventions targeting emotional adjustment to physical impairment are needed for treating depression in heart failure.
  • Current antidepressant treatment status in this population was also described.
Abstract

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