Depression linked to death among heart failure patients

October 31, 1999

Depressed mood is significantly related to increased mortality risk among people with congestive heart failure, say the results of a new study conducted in a Norwegian hospital outpatient cardiology practice. Patients who were deemed to have "severe depression" were approximately four times as likely to die within two years after they entered the study than those who were classified as "not depressed."

"This study has important implications for the treatment of congestive heart failure patients," said Terje A. Murberg, M.Sc., the lead researcher. "The results suggest that health professionals should be especially alert to depression in congestive heart failure patients and should strive to provide appropriate treatment for depression when needed."

Participants in the study included 119 clinically stable patients with congestive heart failure who attended the outpatient practice at the Central Hospital in Rogaland, Stavanger, Norway. The patients' average age was 66, and the average time since onset of heart failure was 61 months. Just over half of the patients (55.5 percent) were retired. Fifteen percent of the patients were employed, and 29.4 percent were on sick leave or not working permanently because of disability. Twenty of the patients died during the two-year data collection period, all from cardiac causes.

Few studies have focused on the effect of depression on mortality among congestive heart failure patients, the investigators note. This study shows a significant association, even when controlling for the severity of the disease. Therefore, the researchers recommend that further research be conducted on the mechanisms linking depressed mood and mortality in heart failure patients. The results of the study appear in the current issue of the International Journal of Psychiatry in Medicine.

The researchers evaluated each study participant for depressive symptoms; emotional problems related to congestive heart failure; the patient's perceptions of his or her physical limitation and dyspnea; and severity of heart failure, as measured by the patient's level of proANF, a peptide that is associated with congestive heart failure.

The results showed that patients who died had significantly higher scores on the self-rating scale used to measure depression than did those who survived. Furthermore, 25 percent of the depressed patients died, compared to 11.3 percent of the non-depressed patients.

The research was supported by the Central Hospital in Rogaland and Hjertelaget Research Foundation, Stavanger, Norway.
The International Journal of Psychiatry in Medicine is published quarterly by Baywood Publishing Company and covers biopsychosocial aspects of primary care. For information about the journal, contact Thomas E. Oxman, M.D., at 603-650-6147.

Posted by the Center for the Advancement of Health For information about the Center, call Petrina Chong, 202-387-2829.

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