Predictors of No Depression in Hospitalized Heart Failure Patients with Reduced Ejection Fraction

OBJECTIVE
Mental health is directly related to mortality in heart failure (HF) patients. Nevertheless, depression are often underdiagnosed and undertreated in HF patients. We aimed to determine the parameters associated with no depression in hospitalized HF patients.

METHODS
A total of 143 hospitalized HF patients with reduced ejection fraction were included in this study. Patient Health Questionnaire-9(PHQ-9) scale was used for screening of depression symptoms. HF patients who scored <5 defined as the patients with no depression were compared with HF patients who scored ≥5.

RESULTS
There were no depression in 65(45.5%) of 143 hospitalized HF patients. Diabetes mellitus(p=0.006),B-blocker usage(p=0.011) were less frequent, NYHA class(p=0.003) and BNP levels(p=0.006) were lower and eGFR levels (p=0.038) were higher in the HF patient with no depression in our study.
In mutivariate analysis, NYHA class [p=0.003,OR(95%CI) 0.426(0.242–0.751)] and B-blocker usage [p=0.045,OR(95%CI) 0.288(0.085–0.972)] were independently correlated with no depression in hospitalized HF patients. In correlation analysis, significant positive correlation was found between NYHA class and PHQ-9 score (r=0.258,p=0.002).

CONCLUSION
45.5% of the hospitalized HF patients had no depression in our study. Diabetes mellitus and B-blocker usage were less frequent, NYHA class and BNP levels were lower and eGFR levels were higher in the HF patient with no depression in our study. Also, NYHA class and B-blocker usage were independent predictor for no depression in hospitalized HF patients. This study emphasized that physicians should be aware of strong interraction with depression and HF. Also, physicians should incorporate regular depression screening into clinical practice.