Self-care and depression in patients with chronic heart failure

Holzapfel, Nicole; Löwe, Bernd; Wild, Beate; Schellberg, Dieter; Zugck, Christian; Remppis, Andrew; Katus, Hugo A.; Haass, Markus; Rauch, Bernhard; Jünger, Jana; Herzog, Wolfgang; Müller-Tasch, Thomas

doi:10.1016/j.hrtlng.2008.11.001

« Previous Next »Heart & Lung: The Journal of Acute and Critical Care
Volume 38, Issue 5 , Pages 392-397, September 2009

Self-care and depression in patients with chronic heart failure

Nicole Holzapfel, MA
- Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Germany
- Reprint requests: Nicole Holzapfel, MA, Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg
Bernd Löwe, MD, PhD
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Hamburg-Eilbek (Schön Clinics), Germany
Beate Wild, PhD
- Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Germany
Dieter Schellberg, MA
- Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Germany
Christian Zugck, MD
- Department of Cardiology, Medical Hospital, University of Heidelberg, Germany
Andrew Remppis, MD
- Department of Cardiology, Medical Hospital, University of Heidelberg, Germany
Hugo A. Katus, MD
- Department of Cardiology, Medical Hospital, University of Heidelberg, Germany
Markus Haass, MD
- Department of Cardiology, Theresien Hospital Mannheim, Germany
Bernhard Rauch, MD
- Department of Cardiology, Medical Hospital Ludwigshafen, Germany
Jana Jünger, MD
- Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Germany
Wolfgang Herzog, MD
- Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Germany
Thomas Müller-Tasch, MD
- Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Germany

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.