Depression affects 24%-42% of congestive heart failure patients and is an independent risk factor for readmission and mortality, with CBT and SSRIs recommended as the most effective treatments.
What are the recommended assessment and treatment strategies for depression in patients with congestive heart failure?
Depression is highly prevalent in CHF and should be assessed and treated with CBT and/or SSRIs, avoiding tricyclic antidepressants.
The prevalence rates of depression in congestive heart failure patients range from 24%-42%. Depression is a graded, independent risk factor for readmission to the hospital, functional decline, and mortality in patients with congestive heart failure. Physicians can assess depression by using the SIG E CAPS + mood mnemonic, or any of a number of easily administered and scored self-report inventories. Cognitive-behavior therapy is the preferred psychological treatment. Cognitive-behavior therapy emphasizes the reciprocal interactions among physiology, environmental events, thoughts, and behaviors, and how these may be altered to produce changes in mood and behavior. Pharmacologically, the selective serotonin reuptake inhibitors are recommended, whereas the tricyclic antidepressants are not recommended for depression in congestive heart failure patients. The combination of a selective serotonin reuptake inhibitor with cognitive-behavior therapy is often the most effective treatment.
Guck et al. (Thu,) conducted a review in Congestive heart failure and depression. Cognitive-behavior therapy and selective serotonin reuptake inhibitors was evaluated. Depression affects 24%-42% of congestive heart failure patients and is an independent risk factor for readmission and mortality, with CBT and SSRIs recommended as the most effective treatments.