Anxiety and depression status of patients with heart failure

Yıl 2022, Cilt: 15 Sayı: 3, 619 - 626, 01.07.2022

Ozge ozden Tok , Yasin Yılmaz , Ayşe Sakallı Kani , Ezgi İnce Guliyev , Burcak Kılıckıran Avcı , Zerrin Yiğit , İbrahim Balcıoğlu , Zeki Öngen

https://doi.org/10.31362/patd.1076241

Öz

Objective: Heart failure (HF) is characterized by chronic, progressive impairment of cardiac functions and is associated with high mortality and morbidity. Psychological symptoms such as depression and anxiety are common among patients with HF and related to mortality, poor function, and treatment adherence failure. In this study we aimed to screen the depression and anxiety symptoms among patients with HF.
Materials and methods: In this cross-sectional, observational study, the Hospital Anxiety and Depression Scale (HAD) was used. A total number of 140 patients diagnosed with HF (94 male, 46 female) under follow-up for at least one year were enrolled into study. Statistical analyses were performed using SPSS.
Results: The mean depression score was 9.5±3.9, and the mean anxiety score was 8.9±4.1. According to the cut-off scores, 74% of the patients had depressive symptoms, whereas 39% of the patients regarded as having anxiety symptoms. The depression and anxiety scores were significantly higher in NYHA Class 3-4 patients compared with those in NYHA Class 1-2. There is positive correlation between duration of disease and depression scores. Patients sleeping less than 6 hours had higher level of depression and anxiety scores.
Conclusion: The present study provides evidence of high prevalence rates of depression and anxiety symptoms in patients with HF. This study might guide us to psychological or medical treatment for psychological disorders among patients with HF.

Anahtar Kelimeler

Depression, anxiety, heart failure, Hospital Anxiety and Depression scale (HAD)

Kalp yetersizliği hastalarında depresyon ve anksiyete

Öz

Amaç: Kalp yetersizliği, kalp fonksiyonlarının kronik, ilerleyici bozukluğu ile karakterize, yüksek mortalite ve morbiditesi olan bir durumdur. Depresyon ve anksiyete gibi psikolojik semptomlar kalp yetersizliği hastalarında sık görülmekle birlikte, mortalite, fonksiyon bozukluğu ve tedaviye uyum zorluğu gibi sorunlarla da ilişkilidir. Bu çalışmada, kalp yetersizliği hastalarında depresyon ve anksiyete semptomlarını araştırmayı planladık.
Gereç ve yöntem: Bu kesitsel gözlem çalışmasında Hastane Anksiyete ve Depresyon Ölçeği (HAD) kullanılmıştır. Kalp yetersizliği tanılı toplamda 140 hasta (94 erkek, 46 kadın) çalışmaya dahil edilmiştir. İstatistiki analiz için SPSS programı kullanılmıştır.
Bulgular: Ortalama depresyon skoru 9,5±3,9 ve ortalama anksiyete skoru 8,9±41 bulundu. Kesme puanı değerlerine göre hastaların %74’ünde depresyon ve %39’unda anksiyete semptomu saptandı. Depresyon ve anksiyete skoru NYHA sınıf 3-4’te diğer sınıflara göre daha yüksek bulundu. Hastalığın süresi ile depresyon arasında pozitif korelasyon saptandı. Hastaların %45’inde aynı zamanda Diabetes Mellitus (DM) tespit edildi. Günde 6 saatten az uyuyan hastaların depresyon ve anksiyete skorları daha yüksek bulundu.
Sonuç: Çalışmamızda, kalp yetersizliği olan hastalarda yüksek oranda depresyon ve anksiyete semptomu saptanmıştır. Bu sonuçlar, kalp yetersizliği olan hastaların psikolojik semptomları için tedavi gereksinimi olduğunu göstermektedir.

Anahtar Kelimeler

Depresyon, anksiyete, kalp yetersizliği, Hastane Anksiyete ve Depresyon Ölçeği (HAD)

Kaynakça

• 1. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation 2019;139(10):e56–528.
• 2. Değertekin M, Erol Ç, Ergene O, Tokgözoğlu L, Aksoy M, Erol MK, et al. Heart failure prevalence and predictors in Turkey: HAPPY study. Arch Turk Soc Cardiol 2012;40:298-308
• 3. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al; ESC Scientific Document Group. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016;37:2315–81.
• 4. Konstam V, Moser DK, De Jong MJ. Depression and anxiety in heart failure.J Card Fail. 2005;11(6):455-63.
• 5. Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol 2006;48(8):1527-37.
• 6. Sokoreli I, de Vries JJG, Pauws SC, Steyerberg EW. Depression and anxiety as predictors of mortality among heart failure patients: systematic review and meta-analysis. Heart Fail Rev. 2016;21(1):49-63.
• 7. Di Palo KE. Psychological Disorders in Heart Failure. Heart Fail Clin. 2020 ;16(1):131-138.
• 8. Pushkarev GS, Kuznetsov VA, Fisher YA, Soldatova AM, Enina TN. Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device. Turk Kardiyol Dern Ars. 2018;46(6):479-487.
• 9. Zigmund AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983; 67:361-370.
• 10. Aydemir Ö, Güvenir T, Küey L, Kültür S. Validity and reliability of Turkish version of Hospital Anxiety and Depression Scale. Turkish Journal of Psychiatry 1997; 8(4):280-287.
• 11. Kozdağ G, Yaluğ İ, İnan N, Ertaş G, Selekler M, Kutlu H, et al. Major depressive disorder in chronic heart failure patients: Does silent cerebral infarction cause major depressive disorder in this patient population? Turk Kardiyol Dern Ars. 2015;43(6):505-12.
• 12. Sbolli M, Fiuzat M, Cani D, O'Connor CM. Depression and heart failure: the lonely comorbidity. Eur J Heart Fail. 2020;22(11):2007-2017.
• 13. Celano CM, Villegas AC, Albanese AM, Gaggin HK, Huffman JC. Depression and Anxiety in Heart Failure: A Review. Harv Rev Psychiatry. 2018;26(4):175-184.
• 14. Newhouse A, Jiang W. Heart failure and depression. Heart Fail Clin 2014;10(2):295–304.
• 15. Daskalopoulou M, George J, Walters K, Osborn DP, Batty GD, Stogiannis D et al. Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1. 9 Million Women and Men. PLoS One. 2016; 11:e0153838.
• 16. White JR, Chang CC, So-Armah KA, Stewart JC, Gupta SK, Butt AA, et al. Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans: Veterans Aging Cohort Study. Circulation. 2015;132:1630–8.
• 17. Freedland KE, Carney RM, Rich MW, Steinmeyer BC, Rubin EH. Cognitive behavior therapy for depression and self-care in heart failure patients: a randomized clinical trial. JAMA Intern Med 2015;175(11):1773–82.
• 18. Blumenthal JA, Babyak MA, O’connor C, Keteyian S, Landzberg J, Howlett J, et al. Effects of exercise training on depressive symptoms in patients with chronic heart failure: the HFACTION randomized trial. JAMA 2012;308(5): 465–74.
• 19. Tu R-H, Zeng Z-Y, Zhong G-Q, Wu WF, Lu YJ, Bo ZD, et al. Effects of exercise training on depression in patients with heart failure: a systematic review and meta-analysis of randomized controlled trials. Eur J Heart Fail 2014; 16(7):749–57.
• 20. Milani RV, Lavie CJ, Mehra MR, Ventura HO. Impact of exercise training and depression on survival in heart failure due to coronary heart disease. Am J Cardiol 2011;107(1):64–8.
• 21. Abdelbasset WK, Alqahtani BA. A randomized controlled trial on the impact of moderate-intensity continuous aerobic exercise on the depression status of middle-aged patients with congestive heart failure. Medicine (Baltimore). 2019;98(17):e15344.
• 22. Pozehl B, McGuire R, Norman J. Team-based Care for Cardiac Rehabilitation and Exercise Training in Heart Failure. Heart Fail Clin 2015;11(3):431-49.
• 23. Das A, Roy B, Schwarzer G, Silverman MG, Ziegler O, Bandyopadhyay D, et al. Comparison of treatment options for depression in heart failure: a network meta-analysis. J Psychiatr Res 2019;108:7–23.
• 24. Yohannes AM, Willgoss TG, Baldwin RC, Connolly MJ. Depression and anxiety in chronic heart failure and chronic obstructive pulmonary disease: prevalence, relevance, clinical implications and management principles. Int J Geriatr Psychiatry. 2010;25(12):1209-21.
• 25. Dei Cas A, Khan SS, Butler J, Mentz RJ, Bonow RO, Avogaro A, et al. Impact of diabetes on epidemiology, treatment, and outcomes of patients with heart failure. JACC Heart Fail 2015;3(2):136-45.
• 26. Chen HM, Clark AP. Sleep disturbances in people living with heart failure. J Cardiovasc Nurs. 2007;22(3):177-85.
• 27. Suna JM, Mudge A, Stewart I, Marquart L, O'Rourke P, Scott A. The effect of a supervised exercise training programme on sleep quality in recently discharged heart failure patients. Eur J Cardiovasc Nurs 2014;14(3):198–205
• 28. Ahmed A, Aronow WS, Fleg JL. Higher New York Heart Association classes and increased mortality and hospitalization in patients with heart failure and preserved left ventricular function. Am Heart J 2006;151(2):444-50.