Tabish Hussain, Li Yu Shu, Xiang Cheng, Tumenjavkhlan Sosorburam, Id Adji A Seid, Sara Tajammul, Aamra Sartaj.
Depression among congestive heart failure patients: results of a survey from central China.
J Pak Med Students Jan ;1(2):38-42.

Background: Congestive heart failure (CHF), a chronic debilitating disease, is often accompanied by anxiety and/or depression, even after optimal control with therapy. The aims of our study were to estimate the frequency of depression among Chinese patients suffering from CHF and to assess the association of depression with their clinical parameters. Methods: A questionnaire-based study was conducted at Tongji Medical College hospital, Wuhan, China from June 2009 to May 2010. 200 patients with systolic CHF [Left Ventricular Ejection fraction (LVEF) <40%] were classified according to NYHA Functional Classification for heart failure. Depression was evaluated by Beck Depression Inventory (BDI). Patients with a previous history of major depression, psychological disorders, or severe debilitating diseases were excluded. Chi-square and t-test were used to assess the relationship between variables. Results: The mean age of participants was 62 ± 9 years. 76% (n=152) were in NYHA class II, 21% (n=42) were in Class III and 3% (n=6) were in Class IV. A majority of the participants (60%, n=120) suffered from depression with a significant female predominance (73.9% females and 47.1% males, p=0.024). We found that worse NYHA functional status was associated with more severe depression. Majority of the participants in class II heart failure (67.4%) were mildly depressed (BDI ≥10 to <17); whereas majority of patients in class III (64%) and class IV (80%) were severely depressed (BDI score ≥17). Among the 36 patients who were severely depressed, mean blood pressure (140 ± 12/90 ± 9mmHg vs. 135 ± 8/86 ± 7mmHg,p=0.03) and mean blood glucose (147 ± 62mg/dl vs. 131 ± 55mg/dl, p=0.01) were significantly worse than those in patients with mild depression, whereas the converse was true about the LVEF (30 ± 3% in severely depressed vs. 32 ± 4% in mildly depressed, p=0.02). Conclusion:Depression is common among CHF patients. Severe depression is more frequent than mild depression at higher NYHA Classes of CHF and is associated with worse physiologic parameters.

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