Abstract
BackgroundMental health illnesses are associated with frequent hospitalisation and an increased risk of all-cause mortality. Despite the high prevalence of depression in patients with chronic heart failure (CHF), there is a paucity of data on this subject from low and middle-income countries (LMIC). The aim of this study was to determine the prevalence of depression, anxiety, and stress symptoms in patients attending a dedicated CHF clinic.MethodsA prospective study was conducted at an outpatient heart failure clinic in a tertiary academic centre. The study participants completed a Depression, Anxiety and Stress (DASS-21) questionnaire to screen for the presence and severity of depression, anxiety and stress symptoms. Furthermore, the Minnesota Living with Heart Failure Questionnaire (MLHFQ) was completed and used to evaluate the impact of CHF on health-related quality of life (QoL). Descriptive statistics were used to describe patients' characteristics and logistic regression analysis to identify predictors of symptoms of depression.ResultsThe study population comprised of 103 patients, predominantly female (62.1%) with a median age of 53 (interquartile range 38–61) years. Symptoms of depression were reported by 52.4%, with 11.6% reporting symptoms suggestive of extremely severe depression. Anxiety was diagnosed in 53.4% of patients and extremely severe anxiety was reported by 18.4% of patients. Fifty patients were classified as stressed, and only 7.7% had extremely severe stress. More than half of the patients (54.4%) were in New York Heart Association functional class I. The mean left ventricular ejection fraction in the entire cohort was 30% (SD = ± 11.1%). In the multivariable logistic regression model, the MLHFQ score [odds ratio (OR) 1.04, 95% CI:1.02–1.06, p = 0.001] and the six-minute walk test [OR 0.99, 95% CI: 0.98–0.99, p = 0.014] were identified as independent predictors of depression.ConclusionDepression and anxiety symptoms were found in over half of patients attending the CHF clinic. We recommend that mental health screening should be routinely performed in patients with CHF. Prospective, adequately powered, multicentre studies from LMIC investigating the impact of depression, anxiety and stress on CHF outcomes such as health-related QoL, hospitalisation and mortality are required.
Highlights
Chronic heart failure (CHF) is a clinical syndrome associated with a significant reduction in the quality of life (QoL) of the patients affected [1]
It has been established that chronic heart failure (CHF) accompanied by depression, anxiety, and stress is associated with an increased rate of heart failure-related hospitalisation and mortality [4,5,6]
According to studies done in other low and middle-income countries (LMIC), we hypothesize that the prevalence of depression, anxiety, and stress in our patients with CHF is likely to be higher than that of patients residing in high income countries [9, 10]
Summary
Chronic heart failure (CHF) is a clinical syndrome associated with a significant reduction in the quality of life (QoL) of the patients affected [1]. It has been established that CHF accompanied by depression, anxiety, and stress is associated with an increased rate of heart failure-related hospitalisation and mortality [4,5,6]. According to studies done in other LMIC, we hypothesize that the prevalence of depression, anxiety, and stress in our patients with CHF is likely to be higher than that of patients residing in high income countries [9, 10]. Despite the high prevalence of depression in patients with chronic heart failure (CHF), there is a paucity of data on this subject from low and middle-income countries (LMIC). The aim of this study was to determine the preva‐ lence of depression, anxiety, and stress symptoms in patients attending a dedicated CHF clinic
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
