Depression and anxiety in ambulatory patients with heart failure

Psychosomatics. Nov-Dec 2009;50(6):592-8. doi: 10.1176/appi.psy.50.6.592.


Background: Depression and anxiety are common in heart failure, but the prevalence, incidence, and relationship of these conditions to health service use and mortality remains uncertain.

Objective: The authors sought to delineate these parameters and identify patient factors predicting hospitalizations for heart failure and mortality 12 months after their initial diagnosis of heart failure.

Method: The authors utilized a retrospective database cohort of 12,028 ambulatory patients with newly diagnosed heart failure to examine diagnosed depression and anxiety and the relationship of these conditions to health service use and all-cause mortality.

Results: Patients with diagnosed depression and/or anxiety (18% of the cohort) were frequently identified by providers within the first 30 days after a heart failure diagnosis. They subsequently utilized twice as many health services, but they did not show increased mortality risk.

Discussion: Although mental health intervention data for heart failure patients are limited, the prevalence and impact of depression and anxiety in these patients suggest that assessment and intervention efforts appear warranted early in the heart failure process.

MeSH terms

  • Aged
  • Ambulatory Care / methods
  • Ambulatory Care / statistics & numerical data*
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / psychology
  • Cohort Studies
  • Comorbidity
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Female
  • Heart Failure / epidemiology*
  • Heart Failure / psychology
  • Humans
  • Incidence
  • Male
  • Prevalence
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Retrospective Studies
  • Survival Analysis
  • United States
  • United States Department of Veterans Affairs / statistics & numerical data