Depression in paroxysmal and persistent atrial fibrillation patients: a cross-sectional comparison of patients enroled in two large clinical trials†

Abstract

Despite its high clinical relevance, few studies have investigated depression in patients with atrial fibrillation (AF). We aimed to assess whether depressed mood was more common in persistent or paroxysmal AF patients in controlled models and report frequencies of major depressive disorder. Cross-sectional data from two contemporary clinical trials were used to compare paroxysmal (n = 310) and persistent (n = 392) AF patients' depressed mood severity (measured by the Major Depression Inventory) with each trial including only one patient type. A four-category outcome of depressed mood severity was chosen as exposure variable. Ordinal logistic regression was applied to analyse the association of AF type with depressed mood in a crude model and a confounder control model. In the study sample, 8.4% were classified as having major depressive disorder [10.5% of persistent and 5.8% of paroxysmal patients; odds ratio (OR) = 1.89; 95% confidence interval (CI): 1.07-3.37], according to the diagnostic and statistical manual of mental disorders [(diagnostic and statistical manual of mental disorders (DSM-IV)] criteria. In both the age and sex adjusted crude model and in the confounder control model, the association of persistent AF with more severe depressed mood was significant (OR confounder controlled model = 1.44; 95% CI: 1.13-1.75, P = 0.007). Persistent AF patients may suffer from more severe depressed mood than paroxysmal AF patients with similar symptom burden after controlling for relevant factors.