TY - JOUR
T1 - Effects of Depression on Heart Failure Self-Care
AU - Freedland, KENNETH E.
AU - SKALA, JUDITH A.
AU - STEINMEYER, BRIAN C.
AU - CARNEY, ROBERT M.
AU - RICH, MICHAEL W.
N1 - Funding Information:
This study was supported by Grant No. R01HL119286 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/5
Y1 - 2021/5
N2 - Background: Depression has been identified as a barrier to effective heart failure self-care, but recent studies suggest that the relationship between depression and self-care is more complex than was previously believed. This study was designed to clarify the relationship between depression and self-care in hospitalized patients with HF. Methods and Results: During hospitalization with a confirmed clinical diagnosis of HF, 400 patients completed a structured interview to diagnose Diagnostic and Statistical Manual, 5th edition (DSM-5) depressive disorders, the Patient Health Questionnaire (PHQ-9) depression questionnaire, the Self-Care of Heart Failure Index (SCHFI), and several psychosocial questionnaires. Multivariable models were fitted to each SCHFI scale; separate models were run with DSM-5 disorders and PHQ-9 depression scores. Higher PHQ-9 depression scores were independently associated with lower (worse) scores on the SCHFI Maintenance (P < .05), Management (P < .01), and Confidence (P < .01) scales. No independent associations with DSM-5 depressive disorders were detected. Measures of perceived stress, anxiety, and low perceived social support were also significantly associated with poor HF self-care. Conclusions: Patients with a combination of psychosocial problems, including symptoms of depression, stress, anxiety, and inadequate social support, may be more likely than other patients to display difficulties with HF self-care that can increase their risk for hospitalization. Research is needed on “broad-spectrum” psychosocial interventions for patients with HF self-care deficits.
AB - Background: Depression has been identified as a barrier to effective heart failure self-care, but recent studies suggest that the relationship between depression and self-care is more complex than was previously believed. This study was designed to clarify the relationship between depression and self-care in hospitalized patients with HF. Methods and Results: During hospitalization with a confirmed clinical diagnosis of HF, 400 patients completed a structured interview to diagnose Diagnostic and Statistical Manual, 5th edition (DSM-5) depressive disorders, the Patient Health Questionnaire (PHQ-9) depression questionnaire, the Self-Care of Heart Failure Index (SCHFI), and several psychosocial questionnaires. Multivariable models were fitted to each SCHFI scale; separate models were run with DSM-5 disorders and PHQ-9 depression scores. Higher PHQ-9 depression scores were independently associated with lower (worse) scores on the SCHFI Maintenance (P < .05), Management (P < .01), and Confidence (P < .01) scales. No independent associations with DSM-5 depressive disorders were detected. Measures of perceived stress, anxiety, and low perceived social support were also significantly associated with poor HF self-care. Conclusions: Patients with a combination of psychosocial problems, including symptoms of depression, stress, anxiety, and inadequate social support, may be more likely than other patients to display difficulties with HF self-care that can increase their risk for hospitalization. Research is needed on “broad-spectrum” psychosocial interventions for patients with HF self-care deficits.
KW - Depression
KW - depressive disorders
KW - heart failure
KW - self-care
UR - http://www.scopus.com/inward/record.url?scp=85100123372&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2020.12.015
DO - 10.1016/j.cardfail.2020.12.015
M3 - Article
C2 - 33358958
AN - SCOPUS:85100123372
SN - 1071-9164
VL - 27
SP - 522
EP - 532
JO - Journal of cardiac failure
JF - Journal of cardiac failure
IS - 5
ER -