2015


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2015/№6

Is it possible to say something new about depressions in patients with chronic heart failure?

Begrambekova Yu. L.1, Drobizhev M. Yu.2, Mareev V. Yu.1, Kikta S. V.3
1 – Federal State Budgetary Educational Institution of Higher Professional Education “M. V. Lomonosov Moscow State University”, Leninskie Gory 1, GSP-1, Moscow 119991
2 – State Budgetary Educational Institution of Higher Professional Education “I. M. Sechenov First Moscow State Medical University” of the RF Ministry of Health Care, Trubetskaya 8, Bldg. 2, Moscow 119991
3 – Federal State Budgetary Institution, “Polyclinic #3” of the Department for Presidential Affairs of the Russian Federation, Grokholsky Pereulok 31, Moscow 129090

Keywords: CHF, depressive and anxiety disorders, ICD-10

DOI: 10.18087/rhfj.2015.6.2161

Background. Depressive and anxiety disorders are common in patients with HF and attract attention of researchers due to their possible adverse effect on the course of CHF. However, a vast majority of studies indicates only the fact of presence of depressive symptoms without providing an accurate diagnosis and clinical characteristics. Aim. To study structure and clinical and diagnostic characteristics of anxiety and depressive reactions in patients with CHF. Materials and methods. We performed a secondary analysis of the CHANCE (sCHool and outpAtieNt watCh of patients with hEart failure) study database. Severity of depressive and anxiety symptoms was studied during the study (0, 24, and 48 weeks). The Wilcoxon test was used for pairwise comparison of examination results. Also dependence of depressive and anxiety symptom severity on CHF severity (FC) was studied. Results. On enrollment to the study, 60 % of patients had a «subthreshold» HADS total score (<10). Clinically significant anxiety and depression were observed in 40 % of patients. However, the HADS total score did not exceed 14–15, which indicated moderate severity of symptoms. The proportion of patients with subthreshold values for the anxiety subscale increased to 75% at week 24. Mean total score for HADS anxiety and depression scales were observed in patients with more severe HF FCs. Differences between the mean total scores were significant for all patients (one-way ANOVA for anxiety and depression scales, p<0.000001). Conclusion. The presented data show that mental symptoms meet criteria for psychological (“normal”) reactions of patients to CHF in 60 % of patients with HADS subthreshold values. Mild or moderate symptoms probably reflecting a pathological, depressive reaction (F43.2, disordered adaptive reactions) were observed in another 40 % of cases. In a vast majority of cases, the depressive symptoms were reversible and alleviated without any specific therapy against the background of improved somatic condition.
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Begrambekova Yu. L., Drobizhev M. Yu., Mareev V. Yu., Kikta S. V. Is it possible to say something new about depressions in patients with chronic heart failure? Russian Heart Failure Journal. 2015;16 (6):360–367

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