Depression Tied To "Can't Do" Attitude In Men With Congestive Heart Failure

November 24, 1998

Depressed men who have congestive heart failure -- a life-threatening condition -- are more likely than their women counterparts to perceive themselves as physically limited in performing daily tasks, according to Norwegian researchers.

Writing in the fall issue of The International Journal of Psychiatry in Medicine (Vol. 28, No. 3), Terje A. Murberg, M.Sc., of Stavanger College, Stavanger, Norway, and colleagues report that "men may be more attentive to symptoms of functional limitations and perceive these symptoms as more psychologically invasive than do women."

The researchers examined 85 men and 34 women with congestive heart failure, a condition that can leave patients with chest pain, short of breath, and physically debilitated. The patients completed questionnaires assessing both their levels of depression and ability to perform a range of daily tasks. Their physicians also completed similar assessments.

Overall, 32 percent of the men, but 62 percent of the women, reported mild to severe symptoms of depression. This probably reflects women's greater willingness to report depressive symptoms in general rather than any difference in the way congestive heart failure affects men and women, the researchers say.

Physicians' ratings of the patients' functional abilities did not predict their level of depression, the researchers say. Instead, it was the patients' perceptions of their own abilities that was more closely tied to their symptoms of depression -- an effect that was much stronger for men than for women.

Some men, however, reported that they experienced few daily limitations in their activities, despite the fact that their physicians assessed their symptoms of heart failure as severe.

"These findings may simply reflect that some men have high tolerance for congestive heart failure symptoms," the researchers say. It is also possible that men find it less socially acceptable to complain about their health and do not report all their symptoms.

Women, say Murberg and colleagues, may have a more realistic appreciation of their condition. Their ratings of their functional ability more closely matched their physicians' ratings.
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 the editor, Thomas E. Oxman, M.D., at 603-650-6147.

Posted by the Center for the Advancement of Health . For information about the Center contact Richard Hebert, 202-387-2829.

Center for Advancing Health

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