Abstract
BackgroundInitial evidence suggests that depressive symptoms are more frequent in patients with atrial fibrillation. Data from the general population are limited.Methods and ResultsIn 10,000 individuals (mean age 56±11 years, 49.4% women) of the population-based Gutenberg Health Study we assessed depression by the Patient Health Questionnaire (PHQ-9) and a history of depression in relation to manifest atrial fibrillation (n = 309 cases). The median (25th/75th percentile) PHQ-9 score of depressive symptoms was 4 (2/6) in atrial fibrillation individuals versus 3 (2/6) individuals without atrial fibrillation, . Multivariable regression analyses of the severity of depressive symptoms in relation to atrial fibrillation in cardiovascular risk factor adjusted models revealed a relation of PHQ-9 values and atrial fibrillation (odds ratio (OR) 1.04, 95% confidence interval (CI) 1.01–1.08; P = 0.023). The association was stronger for the somatic symptom dimension of depression (OR 1.08, 95% CI 1.02–1.15; P = 0.0085) than for cognitive symptoms (OR 1.05, 95% CI 0.98–1.11; P = 0.15). Results did not change markedly after additional adjustment for heart failure, partnership status or the inflammatory biomarker C-reactive protein. Both, self-reported physical health status, very good/good versus fair/bad, (OR 0.54, 95% CI 0.41–0.70; P<0.001) and mental health status (OR 0.61 (0.46–0.82); P = 0.0012) were associated with atrial fibrillation in multivariable-adjusted models.ConclusionsIn a population-based sample we observed a higher burden of depressive symptoms driven by somatic symptom dimensions in individuals with atrial fibrillation. Depression was associated with a worse perception of physical or mental health status. Whether screening and treatment of depressive symptoms modulates disease progression and outcome needs to be shown.
Highlights
Atrial fibrillation (AF) and its sequelae have become a significant public health burden and cost factor in the health care system due to an increasing prevalence in aging populations [1]
In a population-based sample we observed a higher burden of depressive symptoms driven by somatic symptom dimensions in individuals with atrial fibrillation
Depression was associated with a worse perception of physical or mental health status
Summary
Atrial fibrillation (AF) and its sequelae have become a significant public health burden and cost factor in the health care system due to an increasing prevalence in aging populations [1]. Individuals with AF are at high risk of incident stroke and heart failure, an increased risk of death remains after accounting for these serious complications and other cardiovascular comorbidities. Evidence suggests that depressive symptoms in AF are related to the recurrence of AF episodes [3] and the occurrence of complications of AF such as heart failure and death in the clinical setting [4]. Initial smaller investigations in AF indicate that the disease is frequently accompanied by depressive symptoms which may impact physical activity and quality of life in AF patients [8,3,9]. We hypothesized that in ambulatory individuals from the general population depression is more frequent in AF independent of age, sex and cardiovascular comorbidities. Initial evidence suggests that depressive symptoms are more frequent in patients with atrial fibrillation.
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