Left Ventricular Dysfunction and Depression in Hospitalized Patients with Heart Failure.
Left Ventricular Dysfunction and Depression in Hospitalized Patients with Heart Failure.
复制标题
DOI：
10.1097/psy.0000000000000915
复制
发表时间：
2021-04-01
影响因子：
3.3
通讯作者：
Rich MW
中科院分区：
文献类型：
--
作者：
Freedland KE;Carney RM;Steinmeyer BC;Skala JA;Rich MW
本研究旨在探讨心力衰竭（HF）患者左心室收缩功能障碍的严重程度是否与抑郁相关。其他因素也进行了研究，以确定HF抑郁症的独立相关因素。样本包括400名住院HF患者。从病历中获得左心室射血分数（LVEF）和其他医疗数据。抑郁症和其他心理社会特征进行了评估，通过访谈和问卷调查。比例优势模型用于测试这些特征与DSM-5抑郁障碍的关系，协方差分析用于测试与二级模型中连续测量抑郁的关系。这些模型没有证据表明LVEF和抑郁症之间存在关联。抑郁症诊断的校正比值比（95%置信区间）为1.00（0.98-1.01），p= 0.87。汉密尔顿抑郁量表的协方差分析估计值（标准误）为-0.01（0.02），p= 0.54，患者健康问卷（PHQ-9）为-0.01（0.01），p= 0.59。抑郁症的几率在非洲裔美国人和那些焦虑或压力水平高的人中更高。在以前的研究中与抑郁症相关的其他特征，包括性别和年龄，在这项研究中与抑郁症并不一致。心力衰竭住院患者左室收缩功能障碍的严重程度与抑郁无相关性。相比之下，非裔美国人患者和那些焦虑或感知压力水平高的患者比其他患者更有可能患有共病抑郁症。
This study examined whether the severity of left ventricular systolic dysfunction is associated with depression in patients with heart failure (HF). Other factors were also studied to identify independent correlates of depression in HF. The sample consisted of 400 hospitalized patients with HF. Left ventricular ejection fraction (LVEF) and other medical data were obtained from medical records. Depression and other psychosocial characteristics were assessed by an interview and questionnaires. Proportional odds models were used to test the relationships of these characteristics to DSM-5 depressive disorders, and analysis of covariance was used to test relationships with continuous measures of depression in secondary models. The models produced no evidence of an association between LVEF and depression. The adjusted odds ratio (95% confidence interval) was 1.00 (0.98–1.01), p=.87 for depression diagnosis. Analysis of covariance estimates (standard error) were −0.01 (0.02), p=.54 for the Hamilton Rating Scale for Depression and −0.01 (0.01), p=.59 for the Patient Health Questionnaire (PHQ-9). The odds of depression were higher in African American patients and in those with high levels of anxiety or stress. Other characteristics that have been associated with depression in previous studies, including sex and age, were not consistently associated with depression in this study. There is no relationship between the severity of left ventricular systolic dysfunction and depression in hospitalized patients with HF. In contrast, African American patients and those with a high level of anxiety or perceived stress are more likely than other patients to have a comorbid depressive disorder.