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Impact of depression on quality of life assessment in heart failure

Hermann Faller1, Thomas Steinbüchel, Stefan Störk

  • 1Department of Internal Medicine I/Center for Cardiovascular Medicine, University of Würzburg, Institute of Psychotherapy und Medical Psychology, Würzburg, Germany. h.faller@uni-wuerzburg.de

International Journal of Cardiology
|January 24, 2009
PubMed

Insights

Depression in chronic heart failure (CHF) patients can skew quality of life reports. While disease severity impacts symptoms, depression distorts the link between severity and overall life satisfaction in CHF patients.

Area of Science:

  • Cardiology
  • Psychiatry
  • Health Outcomes Research

Background:

  • Depression is common in chronic heart failure (CHF) patients.
  • Depression may negatively bias self-reported health-related quality of life (HRQoL).
  • This bias can compromise the validity of CHF-specific HRQoL measures.

Purpose of the Study:

  • To investigate if comorbid depression alters the relationship between CHF disease severity and HRQoL.
  • To assess the impact of depression on the validity of a CHF-specific HRQoL measure.

Main Methods:

  • 233 outpatients with CHF were evaluated.
  • Depression assessed using the Patient Health Questionnaire.
  • CHF severity measured by NYHA functional class; HRQoL by Kansas City Cardiomyopathy Questionnaire (KCCQ).

Main Results:

  • Both NYHA class and depression independently affected KCCQ subscales.
  • A dose-response relationship between disease severity and HRQoL was seen in symptom/function subscales, even in depressed patients.
  • An interaction effect was found in the life satisfaction subscale: depression eliminated the dose-response relationship between disease severity and HRQoL.

Conclusions:

  • Both CHF severity and depression impact HRQoL dimensions.
  • Depression appears to distort the relationship between CHF severity and HRQoL, particularly life satisfaction.
  • Assessing depression is crucial for interpreting HRQoL scores in CHF patients.
Abstract

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