Depression, Anxiety, and Quality of Life in Patients With Atrial Fibrillation

Abstract

To examine the prevalence and persistence of depression and anxiety in patients with atrial fibrillation (AF), and their effect on future quality of life (QoL) status. The Beck Depression Inventory and State-Trait Anxiety Inventory were completed by 101 patients with AF (62 men; mean age +/- SD, 66.3 +/- 11.0 years), who were compared to 97 patients with hypertension (as "disease control" subjects) in sinus rhythm (64 men; mean age, 68.0 +/- 7.2 years) at baseline and at 6 months. QoL was ascertained at both time points using Dartmouth Care Cooperative Information Project charts. At baseline among AF patients, symptoms of depression, state anxiety, and trait anxiety prevailed in 38%, 28%, and 38%, respectively; analogous data for hypertensive patients were 30%, 23%, and 22%. AF patients displayed higher levels of trait anxiety (p < 0.05), with no significant differences in baseline depression, state anxiety, and QoL between patients with AF and disease control subjects. Symptoms of depression and anxiety (state and trait) persisted at 6 months in 36.8% and 33.3%, respectively. Symptoms of depression (p < 0.001) and anxiety (p < 0.001) at baseline, female gender (p = 0.01), ethnicity (p = 0.01), and employment status (p = 0.03) were significantly correlated with QoL at 6 months in the patients with AF. Multiple regression analysis revealed that baseline depression score provided the best independent prediction of 6-month QoL (R(2) = 0.20), although gender and employment status also entered the model. Approximately one third of AF patients have elevated levels of depression and anxiety, which persist at 6 months. Symptoms of depression were the strongest independent predictor of future QoL in these patients.