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European Journal of Heart Failure 2005 7(5):803-808; doi:10.1016/j.ejheart.2005.03.001
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© 2005 European Society of Cardiology

Prevalence and predictors of anxiety and depression in a sample of chronic heart failure patients with left ventricular systolic dysfunction

J.E. Hawortha,*, E. Moniz-Cooka, A.L. Clarkb, M. Wanga, R. Waddingtonc and J.G.F. Clelandb

a Department of Clinical Psychology, Post Graduate Medical Institute, Hertford Building University of Hull, Kingston-upon-Hull HU6 7RX, United Kingdom
b Department of Academic Cardiology, University of Hull Castle Hill Hospital, Cottingham HU16 5JQ, United Kingdom
c Information by Design University of Hull, United Kingdom

* Corresponding author. Present address: Department of Clinical and Health Psychology, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, United Kingdom. Tel.: +44 113 2065897; fax: +44 113 2064079. E-mail address: Jane.Haworth{at}leedsth.nhs.uk


  Abstract

Objective: To determine the prevalence and predictors of anxiety and depression in patients with heart failure due to Left Ventricular Systolic Dysfunction (LVSD).

Background: Psychological adjustment to Chronic Heart Failure (CHF) can be poor, with the prevalence of depression in out-patients ranging from 13% to 48%. The prevalence of anxiety disorders in this population is unknown and the factors that predict anxiety and depression are not well understood.

Methods: 100 out-patients from a community heart failure programme completed a clinical diagnostic interview—the Structured Clinical Interview (SCID-I), to evaluate anxiety and depression. Mean age was 67 ± 11 years, 17% were women and 91% were NYHA Class II or III. Other standardised measures were of cognition, biomedical status, social support and previous physical and mental health history.

Results: The prevalence rates of anxiety and depression (all subtypes) were 18.4% and 28.6%, respectively. Predictors of depression included a reported history of mental ill-health and NYHA class. Predictors of anxiety included a reported history of mental ill-health, co-morbid physical illness (diabetes and angina) and NYHA class. Severity of LVSD did not predict either anxiety or depression.

Conclusions: Both anxiety and depression are common in CHF patients. The data on the predictors of poor psychological adjustment might assist in targeting bio-psychosocial intervention for patients who are at most at risk of anxiety and depression, within community CHF disease management programmes.

Key Words: Heart failure • Out-patients • Depression • Anxiety

Received December 22, 2004; Revised February 22, 2005; Accepted March 24, 2005


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