Magazine article Clinical Psychiatry News

Psychosocial Interventions May Benefit Heart Failure Patients

Magazine article Clinical Psychiatry News

Psychosocial Interventions May Benefit Heart Failure Patients

Article excerpt

NEW ORLEANS -- A brief checklist of social and health factors predicts onset of depressive symptoms in heart failure patients, Edward P. Havranek, M.D., said at the annual scientific sessions of the American Heart Association.

Given those findings, routine screening of high-risk patients with heart failure followed by psychosocial interventions aimed at reducing the incidence of depression deserves study, said Dr. Havranek of Denver Health Medical Center.

"This would be consistent with the Institute of Medicine position that one of the changes necessary for American health care is for the system to anticipate patient needs rather than simply to react to events," he said.

The four-item checklist consists of living alone, alcohol abuse, poor health status as measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ), and the patient's perception that his or her medical care poses a substantial economic burden. A heart failure patient's risk of developing depression within 1 year rises in stepwise fashion as the number of applicable risk factors increases (see chart), Dr. Havranek said.

The checklist was developed as part of a multicenter prospective cohort study involving 245 out-patients with heart failure (HF) and a left ventricular ejection fraction less than 40% who were free of depression at baseline. During 1 year of follow-up, 21.5% of patients developed clinically significant symptoms of depression as defined by a score above 0.06 on the widely used Medical Outcomes Study Depression Scale. …

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