Comparative study of depression in hospitalized and stable heart failure patients in an urban Nigerian teaching hospital

Abstract

Objective There are conflicting reports about the presence of depression in Black patients with heart failure (HF). We therefore evaluated the pattern of depression among hospitalized and stable HF patients in a homogenous Black population. Method Patients hospitalized for new or decompensated HF were assessed. The Zung Self-Rating Depression Scale (SDS) questionnaire was administered to the subjects who were subsequently interviewed by a psychiatrist using the Hamilton Depression Rating Scale (HDRS). Stable HF patients at the outpatient clinic were used as controls. Results There were 123 hospitalized and 82 stable outpatients. Depression was present in 67% of hospitalized patients and 30.50% of the outpatients ( P<.0001, using the SDS indexed scores). Stratifying the SDS indexed scores showed that 45.50%, 19.60% and 1.80% of the hospitalized patients compared with 26.80%, 3.70% and 0% of the outpatients had mild, moderate and severe depression ( P=.007 and P=.001), respectively. The HDRS assessment showed that 63.40% of the hospitalized patients and 28.0% of the stable outpatients had significant depression ( P<.0001). Conclusion Depression affects two thirds of hospitalized urban Nigerian HF patients compared to one third of stable outpatients with HF. The prevalence of depression is similar to the prevalence among European and North American samples.