January 1, 2003Psychosomatic Medicine398 citations
Prevalence of Depression in Hospitalized Patients With Congestive Heart Failure
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Key Result
Hospitalized patients with congestive heart failure had a 20% prevalence of major depression, ranging from 8% in NYHA class I to 40% in class IV.
Key Points
- To establish the prevalence of major and minor depression in hospitalized patients with congestive heart failure and identify clinical, demographic, and psychosocial factors influencing these rates.
- Assessed 682 hospitalized congestive heart failure patients using a modified Diagnostic Interview Schedule for DSM-IV major and minor depression criteria.
- Administered the Beck Depression Inventory to 613 patients and extracted medical, demographic, and echocardiographic data via chart review and interviews.
- Among all participants, 20% met DSM-IV criteria for major depression, 16% met criteria for minor depression, and 51% scored ≥10 on the Beck Depression Inventory.
- Prevalence of major depression varied markedly by disease severity, ranging from 8% in New York Heart Association class I failure to 40% in class IV failure.
- Rates also differed significantly by age, sex, employment status, dependence in activities of daily living, and history of major depression.
Study Design
Type
Cross-Sectional (n=682)
Structured PICO
P
Population
682 hospitalized patients with congestive heart failure (CHF)
O
Outcome
Prevalence of DSM-IV major and minor depressionpatient reported
Major depression is highly prevalent (20%) in hospitalized patients with congestive heart failure, with rates increasing significantly with greater functional severity (up to 40% in NYHA class IV).
Abstract
OBJECTIVE: Prevalence estimates of depression in hospitalized patients with congestive heart failure (CHF) differ considerably across studies. This article reports the prevalence of depression in a larger sample of hospitalized patients with CHF and identifies demographic, medical, psychosocial, and methodological factors that may affect prevalence estimates. METHODS: A modified version of the Diagnostic Interview Schedule was administered to a series of 682 hospitalized patients with CHF to determine the prevalence of DSM-IV major and minor depression; 613 patients also completed the Beck Depression Inventory. Medical, demographic, and social data were obtained from hospital chart review, echocardiography, and patient interview. RESULTS: In the sample as a whole, 20% of the patients met the DSM-IV criteria for a current major depressive episode, 16% for a minor depressive episode, and 51% scored above the cutoff for depression on the Beck Depression Inventory (>or=10). However, the prevalence of major depression differed significantly between strata defined by the functional severity of heart failure, age, gender, employment status, dependence in activities of daily living, and past history of major depression. For example, the prevalence ranged from as low as 8% among patients in New York Heart Association class I failure to as high as 40% among patients in class IV. CONCLUSIONS: The prevalence of depression in hospitalized patients with CHF is similar to rates found in post-myocardial infarction patients. However, it is considerably higher in certain subgroups, such as patients with class III or IV heart failure. Further research is needed on the prognostic importance and treatment of comorbid depression in CHF.
Cite This Study
Freedland et al. (2003) conducted a cross-sectional in Congestive Heart Failure (n=682). Hospitalized patients with congestive heart failure had a 20% prevalence of major depression, ranging from 8% in NYHA class I to 40% in class IV.