Depression in patients with chronic heart failure
General Medicine, 2023, 25(6), 20-23.
V. Kolev1, E. Manov1, N. Runev1, B. Stoimenov1, G. Onchev2, R. Pancehva1
1 Deparment of Propedeutics of Internal Diseases “Prof. Stoyan Kirkovich”, Faculty of Medicine, Medical University ‒ Sofia
2 Department of Psychiatry and Medical Psychology, Medical University – Sofia
Abstract. Heart failure (HF) is a chronic cardiac impairment with a substantial impact on patients and healthcare systems due to reduced quality of life, frequent hospitalizations, and high costs. Despite advances, HF remains associated with high mortality rates. Psychiatric illnesses, especially depression, are prevalent in HF patients and exacerbate negative outcomes. Aim. This study aimed to assess the prevalence and severity of depression and anxiety in HF patients. Material and methods. A total of 138 patients with chronic HF were prospectively evaluated. All participants underwent assessments for depression using the Hamilton Depression Rating Scale (HAM-D). Results. Depression was found in 82.6% of patients, with varying degrees of severity. Women were more often affected from depression than men. Factors like older age, high alcohol intake and advanced HF were associated with higher rates of depression. Comorbidities like valvular heart diseases, hypertension, diabetes mellitus, previous myocardial infarction, anemia and chronic kidney disease increased depression risk. Cardiac surgical procedures also correlated with elevated depression rates. Multivariate analysis revealed anemia, chronic kidney disease, ejection fraction below 50%, and alcohol consumption as predictors of depression. Conclusion. The study highlights the significance of addressing depression and anxiety in HF patients for better outcomes. Early screening, cognitive behavioral therapy, exercise, and appropriate medication are the recommended interventions.
Key words: depression, heart failure
Address for correspondence: Vasil Kolev, e-mail: kolevvasil@yahoo.com