Self-care and depression in patients with chronic heart failure
published online 22 January 2009.
Background
Although chronic heart failure (CHF) is often complicated by comorbid depression and poor self-care, little is known about their specific association in patients with CHF.
Objective
To investigate self-care behavior among patients with CHF with different degrees of depression severity.
Methods
A total of 287 patients with documented CHF, New York Heart Association functional class II to IV, completed the European Heart Failure Self-Care Behavior Scale. The Structured Clinical Interview for DSM (SCID) IV served as the criterion standard for the presence of a depressive disorder.
Results
Analyses of covariance and linear regression analyses revealed that patients with CHF with minor depression reported significantly lower levels of self-care than patients with major depression (P = .003) and nondepressed patients (P = .014). In addition to minor depression, age (P ≤ .001), multimorbidity (P = .01), left ventricular ejection fraction (P = .001), and family status (P = .01) were determinants of self-care.
Conclusion
Our results demonstrate that patients with CHF with minor depression and not major depression are at higher risk for poor self-care and its resulting consequences, such as symptom deterioration and frequent hospitalization.
aDepartment of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Germany
bDepartment of Cardiology, Medical Hospital, University of Heidelberg, Germany
cDepartment of Cardiology, Theresien Hospital Mannheim, Germany
dDepartment of Cardiology, Medical Hospital Ludwigshafen, Germany
eDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Hamburg-Eilbek (Schön Clinics), Germany
Reprint requests: Nicole Holzapfel, MA, Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg
The study was supported by the German Heart Failure Network, funded by the German Ministry of Education and Research (BMBF), FKZ 01GI0205.
ABSTRACT