Screening, assessment and treatment for depression in patients with chronic heart failure

Abstract

Patients with chronic heart failure (CHF) have clinically significant depression at a rate two to three times higher than the general population. Depression is associated with poorer survival, limitations in daily functioning, and more frequent adverse cardiac outcomes. Guidelines on the management of CHF have highlighted a need for screening and assessment of depression in patients with CHF using validated instruments such as the Beck Depression Inventory and the Patient Health Questionnaire, which should be administered routinely post-hospitalisation, while recognising that not all symptoms are related to CHF alone. Following referral to a mental health specialist, collaborative care, cognitive behavioural therapy, and positive psychology interventions are most likely to deliver benefits for depression in people with CHF. They may also benefit from assistance with any limitations in terms of physical activity and fatigue, health behaviours, social isolation, and adherence to their medical treatment.