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Wang Y, Xu X, Lv Q, Zhang X, Zhao Y, Zang X. Dose-Response Relationship Between Perceived Control and Depression in Patients With Chronic Heart Failure: A Multicenter and Cross-sectional Study. J Cardiovasc Nurs 2024:00005082-990000000-00199. [PMID: 38896538 DOI: 10.1097/jcn.0000000000001117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
BACKGROUND Little is known regarding the relationship between perceived control and depression in patients with chronic heart failure (CHF), particularly in terms of their dose-response relationship. OBJECTIVE The aim of this study was to explore this relationship based on linear and nonlinear hypotheses and potential subgroup differences in patients with CHF. METHODS A total of 308 patients with CHF were included in the study. Data on perceived control, depression, and relevant covariates, such as gender, age, New York Heart Association classification, and comorbidity burden, were collected. Logistic regression, Spearman correlation, and restricted cubic spline analysis were used for data analysis. RESULTS Compared with the patients in the first quartiles of perceived control scores (0-16), those in the other 3 quartiles had a lower risk of depression (odds ratios of 0.29, 0.21, and 0.20, respectively; P < .05). Furthermore, a negative correlation between perceived control and depression (r = -0.317, P < .01) was observed. The restricted cubic spline analysis revealed an "L-shaped" curve relationship between perceived control and the presence of depression (P for nonlinear < .01). Compared with patients with a perceived control within the 5th percentile (10 scores), as the perceived control increased, the risk of depression rapidly decreased from "1" until it reached a threshold (20 scores) and stabilized. This trend remained consistent across the subgroups grouped by gender, age, New York Heart Association classification, and comorbidity burden. CONCLUSIONS Interventions targeting perceived control may hold valuable implications for reducing the risk of depression in patients with CHF, particularly those who have not yet reached the threshold.
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Mulugeta H, Sinclair PM, Wilson A. Comorbid depression among adults with heart failure in Ethiopia: a hospital-based cross-sectional study. BMC Psychiatry 2024; 24:321. [PMID: 38664670 PMCID: PMC11044455 DOI: 10.1186/s12888-024-05748-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/08/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Depression is a common comorbidity in adults with heart failure. It is associated with poor clinical outcomes, including decreased health-related quality of life and increased morbidity and mortality. There is a lack of data concerning the extent of this issue in Ethiopia. Consequently, this study aimed to assess the prevalence of comorbid depression and associated factors among adults living with heart failure in Ethiopia. METHODS A hospital-based cross-sectional study was conducted at the cardiac outpatient clinics of two selected specialist public hospitals in Addis Ababa, Ethiopia: St. Paul's Hospital Millennium Medical College and St. Peter Specialized Hospital. An interviewer-administered questionnaire was used to collect data from 383 adults with heart failure who attended the clinics and met the inclusion criteria. Depression was measured using the Patient Health Questionnaire (PHQ-9). A binary logistic regression model was fitted to identify factors associated with depression. All statistical analyses were conducted using STATA version 17 software. RESULTS The mean age of the participants was 55 years. On average, participants had moderate depression, as indicated by the mean PHQ-9 score of 11.02 ± 6.14, and 217 (56.6%, 95%CI 51.53-61.68) had comorbid depression. Significant associations with depression were observed among participants who were female (AOR: 2.31, 95%CI:1.30-4.08), had comorbid diabetes mellitus (AOR: 3.16, 95%CI: 1.47-6.82), were classified as New York Heart Association (NYHA) class IV (AOR: 3.59, 95%CI: 1.05-12.30), reported poor levels of social support (AOR: 6.04, 95%CI: 2.97-12.32), and took more than five medications per day (AOR: 5.26, 95%CI: 2.72-10.18). CONCLUSIONS This study indicates that over half of all adults with heart failure in Ethiopia have comorbid depression, influenced by several factors. The findings have significant implications in terms of treatment outcomes and quality of life. More research in the area, including interventional and qualitative studies, and consideration of multifaceted approaches, such as psychosocial interventions, are needed to reduce the burden of comorbid depression in this population.
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Affiliation(s)
- Henok Mulugeta
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Amhara Region, Ethiopia.
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Peter M Sinclair
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Amanda Wilson
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Cheng L, Zhong Z, Ding S, Duan Y, Sun N, Zheng F. Low body mass index and disease duration as factors associated with depressive symptoms of Chinese inpatients with chronic heart failure. J Health Psychol 2023; 28:1227-1237. [PMID: 37209015 DOI: 10.1177/13591053231173583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023] Open
Abstract
Depression is common in patients with chronic heart failure (CHF), and is associated with an increased risk of adverse health outcomes. There is a paucity of data on this subject from the developing countries. The aim was to examine the prevalence and related factors of depressive symptoms among Chinese inpatients with CHF. A cross-sectional study was conducted. PHQ-9 questionnaire was used to assess depressive symptoms. The overall prevalence of depressive symptoms was 7.5%. Low BMI (OR = 4.837, CI = 1.278-18.301, p = 0.02), disease duration 3-5 years (OR = 5.033, CI = 1.248-20.292, p = 0.023) and 5-10 years (OR = 5.848, CI = 1.440-23.744, p = 0.013) were risk factors for depressive symptoms, while being married (OR = 0.304, CI = 0.123-0.753, p = 0.010) was protective factor. We should pay more attention to patients without a spouse, with low BMI and whose disease duration is between 3 and 10 years in Chinese inpatients with CHF.
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Affiliation(s)
| | | | | | | | - Na Sun
- Central South University, China
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Husain N, Kiran T, Chaudhry IB, Sultan S, Dawood S, Lunat F, Nizami A, Shanahan L, Qureshi A, Un Nisa Z, Husain M, Shakoor S, Alvi MH, Zadeh Z, Memon R, Chaudhry N. Integrated Moving on After Breast Cancer and Culturally Adapted Cognitive Behavior Therapy intervention for depression and anxiety among Pakistani women with breast cancer: Protocol of a randomized controlled trial. SAGE Open Med 2023; 11:20503121231177549. [PMID: 37441193 PMCID: PMC10333993 DOI: 10.1177/20503121231177549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/05/2023] [Indexed: 07/15/2023] Open
Abstract
Objective The diagnosis and treatment of breast cancer is associated with significant distress that has huge impact on survivors' quality of life. The objective of this study is to assess the effectiveness of an integrated intervention "Moving on After Breast Cancer (ABC) Plus culturally adapted Cognitive Behavior Therapy" (Moving on ABC Plus). Method This is a randomized controlled trial that aims to recruit 354 breast cancer survivors from the inpatient and outpatient oncology departments in public and private hospitals in Karachi, Hyderabad, Lahore, Multan, and Rawalpindi in Pakistan. Patients scoring 10 or above on either the Patient Health Questionnaire-9 and/or the Generalized Anxiety Disorder scale (GAD-7) will be recruited. Baseline assessments will include Functional Assessment of Cancer Therapy-Breast; EuroQol-5D; Multidimensional Scale for Perceived Social Support; Intrusive Thoughts Scale; and Rosenberg Self-Esteem Scale. Participants randomized into intervention arm, Moving on ABC Plus, will receive 12 individual therapy sessions over 4 months. Follow-up will be completed at 4- and 6-month post-randomization, using all baseline instruments along with the Client Satisfaction Questionnaire (CSQ-8). We will also explore the participants', their family members', and the therapists' experiences of the trial and intervention. Results We will be assessing the effectiveness of intervention in reducing depression and anxiety in breast cancer survivors as a primary outcome of the trial. The secondary outcomes will include effectiveness of intervention in terms of reduction in intrusive thoughts and improvement in health-related quality of life, self-esteem, and perceived social support. Conclusion The results of the study will inform the design of a future larger randomized control trial with long-term follow-up.
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Affiliation(s)
- Nusrat Husain
- Division of Psychology and Mental
Health, University of Manchester, Manchester, UK
- Manchester Global foundation,
Manchester, UK
| | - Tayyeba Kiran
- Manchester Global foundation,
Manchester, UK
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | | | - Sarwat Sultan
- Department of Psychology, Bahauddin
Zakaria University, Multan, Pakistan
| | - Saima Dawood
- Center for Clinical Psychology,
University of Punjab, Lahore, Pakistan
| | - Farah Lunat
- Lancashire and South Cumbria NHS
Foundation Trust, Preston, UK
| | - Asad Nizami
- Institute of Psychiatry, Benazir Bhutto
Hospital, Rawalpindi, Pakistan
| | | | - Afshan Qureshi
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Zaib Un Nisa
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Mina Husain
- South London and Maudsley NHS
Foundation Trust, London, UK
| | - Suleman Shakoor
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Mohsin H Alvi
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Zainab Zadeh
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Rakhshi Memon
- Manchester Global foundation,
Manchester, UK
- Department of Science and Technology
Studies, University College London, London, UK
| | - Nasim Chaudhry
- Manchester Global foundation,
Manchester, UK
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
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Global prevalence of depression, anxiety, and stress in cardiac patients: A systematic review and meta-analysis. J Affect Disord 2023; 324:175-189. [PMID: 36584710 DOI: 10.1016/j.jad.2022.12.055] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cardiovascular disease is one of the most common chronic and life-threatening diseases. Due to the changes made in the normal living conditions of people after suffering from cardiovascular diseases, the appearance of symptoms of depression, anxiety, and stress is common among these patients. The results of the studies show the different prevalence of these disorders, so this study aimed to standardize the global prevalence of depression, anxiety, and stress in Cardiac patients by a systematic review and meta-analysis approach. METHODS The present systematic review and meta-analysis were conducted from 2000 to 2022. National and international databases were considered to retrieve related studies, including SID, Magiran, Scopus, Embase, PubMed, and Web of Science (WoS). Joanna Briggs Institute (JBI) checklist was used to evaluate studies qualitatively. Heterogeneity between studies was assessed by I2 index, and data analysis was performed in Comprehensive Meta-Analysis software. RESULTS After reviewing the retrieved studies, finally 68 studies on the prevalence of depression with a sample size of 110,219, 36 studies on the prevalence of anxiety with a sample size of 72,374 and 5 studies on the prevalence of stress with a sample size of 533 considered for the meta-analysis. Based on the results of the Meta-Analysis, the overall estimation of the prevalence of depression was 31.3 % (95 % confidence interval: 25.4/0.38 %), anxiety prevalence; 32.9 % (95 % confidence interval: 21.9-46.6 %) and stress prevalence was 57.7 % (95 % confidence interval: 45.3-3.3 %). CONCLUSION The result of the present study shows the high prevalence rate of depression, anxiety, and stress in cardiac patients. Therefore, it is recommended that health professionals and policymakers pay more attention to preventing and controlling these disorders.
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Mulugeta H, Sinclair PM, Wilson A. Prevalence of depression and its association with health-related quality of life in people with heart failure in low- and middle-income countries: A systematic review and meta-analysis. PLoS One 2023; 18:e0283146. [PMID: 36952483 PMCID: PMC10035817 DOI: 10.1371/journal.pone.0283146] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/02/2023] [Indexed: 03/25/2023] Open
Abstract
INTRODUCTION Heart failure is a growing public health concern around the world. People with heart failure have a high symptom burden, such as depression, which affects health-related quality of life (HRQoL). The objective of this systematic review and meta-analysis was to estimate the pooled prevalence of depression and evaluate its association with HRQoL among people with heart failure in low- and middle-income countries (LMICs). METHODS This systematic review was conducted in accordance with the JBI methodology. Electronic databases such as MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, Scopus and JBI EBP were searched to identify relevant studies published from January 2012 to August 2022. The methodological quality of each article was assessed using relevant JBI critical appraisal instruments. A random-effects model was employed to estimate the pooled prevalence of depression. Heterogeneity across the studies was investigated using Cochrane's Q test and I2 statistic. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines 2020 were followed for reporting the results. All statistical analyses were performed using STATA version 17 software. RESULTS After screening, a total of 21 eligible articles with 5074 participants with heart failure were included in this review. The pooled prevalence of depression among people with heart failure in LMICs was 51.5% (95% CI = 39.7, 63.3%, I2 = 99.00%). Subgroup analysis revealed, the highest prevalence in studies whose participants were in-patients, and from the Middle East and North Africa, and studies utilizing Becks Depression Inventory (BDI). Depression was positively associated with HRQoL. CONCLUSION This review revealed that almost half of all people with heart failure in low- and middle-income countries have comorbid depression. People with heart failure and depressive symptoms had poor HRQoL. Therefore, early screening of depression is critical for improving HRQoL in this population. Systematic review registration: PROSPERO CRD42022361759.
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Affiliation(s)
- Henok Mulugeta
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Amhara Region, Ethiopia
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Peter M Sinclair
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Amanda Wilson
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Abstract
BACKGROUND Depression and anxiety are common comorbidities in heart failure (HF) and are associated with adverse outcomes including unplanned hospitalization. However, there is insufficient evidence on the factors associated with depression and anxiety for community patients with HF to inform optimal assessment and treatment in this population. AIM The aim of this study was to examine the prevalence of and factors associated with depression and anxiety in community-dwelling patients with HF. METHODS A retrospective cohort study of 302 adult patients given a diagnosis of HF referred to United Kingdom's largest specialist cardiac rehabilitation center, from June 2013 to November 2020. Main study outcomes were symptoms of depression using Patient Health Questionnaire-9 and anxiety using the General Anxiety Disorder 7-item scale. Explanatory variables included demographic and clinical characteristics and functional status from the Dartmouth COOP questionnaire: quality of life, pain, level of social activity and daily activities, and being bothered by emotional problems (feelings). Logistic regressions were performed to evaluate the association between demographic and clinical characteristics and depression and anxiety. RESULTS Of the sample, 26.2% reported depression and 20.2% had anxiety. Higher depression and anxiety were associated with difficulty in performing daily activities (95% confidence interval, 1.11-6.46 and 1.13-8.09, respectively) and being bothered by feelings (95% confidence interval, 4.06-21.77 and 4.25-22.46, respectively). Depression was associated with limitations in social activity (95% confidence interval, 1.06-6.34) and anxiety with distressing pain (95% confidence interval, 1.38-7.23). CONCLUSION Findings indicate the importance of psychosocial interventions for patients with HF to minimize and manage depression and anxiety. Patients with HF may benefit from interventions targeted to maintain independence, promote participation in social activities, and optimally manage pain.
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Husain MO, Chaudhry IB, Blakemore A, Shakoor S, Husain MA, Lane S, Kiran T, Jafri F, Memon R, Panagioti M, Husain N. Prevalence of depression and anxiety in patients with chronic obstructive pulmonary disease and their association with psychosocial outcomes: A cross-sectional study from Pakistan. SAGE Open Med 2021; 9:20503121211032813. [PMID: 34659761 PMCID: PMC8511919 DOI: 10.1177/20503121211032813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/25/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: Chronic obstructive pulmonary disease contributes to substantial health and
economic burden worldwide. Co-morbid depression and anxiety are highly
prevalent in patients with chronic obstructive pulmonary disease. Depressive
symptoms in chronic obstructive pulmonary disease are associated with poorer
survival, longer hospitalisation and impaired quality of life. Literature on
chronic obstructive pulmonary disease is largely derived from high-income
countries; yet 90% of deaths related to chronic obstructive pulmonary
disease occur in low- and middle-income countries. We aimed to establish the
prevalence of anxiety and depression in patients with chronic obstructive
pulmonary disease, as well as the association with psychosocial
outcomes. Methods: This was a cross-sectional study of chronic obstructive pulmonary disease
patients attending outpatient primary care clinics in Karachi, Pakistan. The
Patient Health Questionnaire-9 was used to assess depression and the
Generalised Anxiety Disorder-7 scale was used for the assessment of anxiety.
Health-related quality of life was assessed with EuroQol–Five Dimensions,
social support with Oslo-3 and social stress with Life Events Checklist. We
recruited 293 subjects. Results: The prevalence of depression and anxiety in the sample was 51%
(n = 149) and 20% (n = 59),
respectively. Depressed chronic obstructive pulmonary disease patients
reported significantly lower health-related quality of life scores as
compared to non-depressed patients. Participants with depression had
significantly higher levels of anxiety, less social support, higher social
stress and more subjective impairment in quality of life. Conclusion: Given the association with reduced social support and increased perceived
stress, the role of psychosocial interventions must be explored in improving
outcomes of chronic obstructive pulmonary disease patients in Pakistan.
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Affiliation(s)
- Muhammad Omair Husain
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada.,Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Imran B Chaudhry
- Department of Psychiatry, Dr. Ziauddin Hospital, Karachi, Pakistan
| | - Amy Blakemore
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Suleman Shakoor
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | | | - Steven Lane
- Medical Statistics Biostatistics, University of Liverpool, Liverpool, UK
| | - Tayyeba Kiran
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Farhat Jafri
- Department of Community Medicine, Karachi Medical & Dental College, Karachi, Pakistan
| | | | - Maria Panagioti
- Division of Population Health, The University of Manchester, Manchester, UK
| | - Nusrat Husain
- Division of Psychology & Mental Health, The University of Manchester, Manchester, UK
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Zhang L, Liu J, Ge Y, Liu M. Ginkgo biloba Extract Reduces Hippocampus Inflammatory Responses, Improves Cardiac Functions And Depressive Behaviors In A Heart Failure Mouse Model. Neuropsychiatr Dis Treat 2019; 15:3041-3050. [PMID: 31754303 PMCID: PMC6825506 DOI: 10.2147/ndt.s229296] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 10/15/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Depression has been shown to share an extremely high comorbidity with heart failure (HF). Ginkgo biloba extract (GBE) is a widely used traditional Chinese medicine in cardiac disease. However, its potential therapeutic effect on depressive symptoms following HF largely remains unknown. In this article, we aimed to investigate its effects in reducing depressive behaviors of a HF mouse model. Moreover, we also discussed whether its effects are associated with changes in neural inflammation and 5-hydroxytryptamine (5-HT) signaling. METHODS Mice were randomly divided into three groups: sham, HF+saline and HF+GBE (150 mg/kg/d) (n=10 per group). Systolic heart failure was induced by ligating the left anterior descending coronary artery. Cardiac functions together with depressive-like behaviors were measured after 4 weeks' treatment. Levels of brain natriuretic peptide (BNP), 5-HT, 5-HT receptor 2A (5-HT2AR), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), vascular endothelial growth factor (VEGF), hypoxia inducible factor-1 (HIF-1), (cleaved) caspase-3, Bax and Bcl-2 were analyzed by Western blot, Elisa and immunohistochemistry at the end of the experiments. RESULTS GBE benefited antidepressant-like behaviors and improved cardiac functions in mice with heart failure. Levels of TNF-α, IL-1β and 5-HT were reduced in the hippocampus after the administration of GBE. Further experiments revealed that GBE also blocked the release of serotonin in the peripheral blood and triggered HIF-1 induced anti-apoptotic pathways. CONCLUSION GBE has potential therapeutic effects in relieving depressive status of patients with HF.
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Affiliation(s)
- Lijun Zhang
- Department of Cardiology, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing 100029, People's Republic of China
| | - Jianyang Liu
- Department of Cardiology, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing 100029, People's Republic of China
| | - Yingbin Ge
- Department of Physiology, Nanjing Medical University, Nanjing, Jiangsu 211166, People's Republic of China
| | - Meiyan Liu
- Department of Cardiology, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing 100029, People's Republic of China
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