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ABSTRACT: Background
Heart failure (HF) is associated with an elevated risk of morbidity, mortality, hospitalization, and impaired quality of life. One potential contributor to these poor outcomes is depression. Yet the effectiveness of treatments for depression in patients with HF is mixed, perhaps due to the heterogeneity of depression.Methods
This secondary analysis applied latent class analysis (LCA) to data from a clinical trial to classify patients with systolic HF and comorbid depression into LCA subtypes based on depression symptom severity, and then examined whether these subtypes predicted treatment response and mental and physical health outcomes at 12 months follow-up.Results
In LCA of 629 participants (mean age 63.6 ± 12.9; 43% females), we identified 4 depression subtypes: mild (prevalence 53%), moderate (30%), moderately severe (12%), and severe (5%). The mild subtype was characterized primarily by somatic symptoms of depression (e.g., energy loss, sleep disturbance, poor appetite), while the remaining LCA subtypes additionally included nonsomatic symptoms of depression (e.g., depressed mood, anhedonia, worthlessness). At 12 months, LCA subtypes with more severe depressive symptoms reported significantly greater improvements in mental quality of life and depressive symptoms compared to the LCA mild subtype, but the incidence of cardiovascular- and noncardiovascular-related readmissions, and mortality was similar among all subtypes.Conclusions
In patients with depression and systolic heart failure those with the LCA mild depression subtype may not meet full criteria for major depressive disorder, given the overlap between HF and somatic symptoms of depression. We recommend requiring depressed mood or anhedonia as a necessary symptom for major depressive disorder in patients with HF.
SUBMITTER: Sadlonova M
PROVIDER: S-EPMC10523864 | biostudies-literature | 2023 Sep-Oct
REPOSITORIES: biostudies-literature
Sadlonova Monika M Chavanon Mira-Lynn ML Kwonho Jeong J Abebe Kaleab Z KZ Celano Christopher M CM Huffman Jeff J Herbeck Belnap Bea B Rollman Bruce L BL
Journal of the Academy of Consultation-Liaison Psychiatry 20230329 5
<h4>Background</h4>Heart failure (HF) is associated with an elevated risk of morbidity, mortality, hospitalization, and impaired quality of life. One potential contributor to these poor outcomes is depression. Yet the effectiveness of treatments for depression in patients with HF is mixed, perhaps due to the heterogeneity of depression.<h4>Methods</h4>This secondary analysis applied latent class analysis (LCA) to data from a clinical trial to classify patients with systolic HF and comorbid depre ...[more]