PMID- 17925137
OWN - NLM
STAT- MEDLINE
DCOM- 20080305
LR  - 20211020
IS  - 0960-1643 (Print)
IS  - 0960-1643 (Linking)
VI  - 57
IP  - 543
DP  - 2007 Oct
TI  - Psychological distress in primary care patients with heart failure: a 
      longitudinal study.
PG  - 801-7
AB  - BACKGROUND: Psychological distress is a common phenomenon in patients with heart 
      failure. Depressive symptoms are often under-diagnosed or inadequately treated in 
      primary care. AIM: To analyse anxiety and/or depression in primary care patients 
      with heart failure according to psychosocial factors, and to identify protective 
      factors for the resolution of psychological distress. DESIGN OF STUDY: 
      Longitudinal observation study. SETTING: Primary care practices in lower Saxony, 
      Germany. METHOD: In 291 primary care patients with heart failure the following 
      factors were measured using validated questionnaires at baseline and 9 months 
      later: anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), 
      quality of life (Minnesota Living with Heart Failure Questionnaire), coping with 
      illness (Freiburg questionnaire for coping with illness), and social support 
      (social support questionnaire). Severity of heart failure (New York Heart 
      Association [NYHA] classification and Goldman's Specific Activity Scale), and 
      sociodemographic characteristics were documented using self-report instruments. 
      RESULTS: Twenty-six (32.5%) of the 80 patients who were distressed at baseline 
      had normal HADS scores 9 months later, while the remainder stayed distressed. In 
      logistic regression, baseline distress (odds ratios [OR] 5.51; 95% confidence 
      intervals [CI] = 2.56 to 11.62), emotional problems (OR = 1.08; 95% CI = 1.00 to 
      1.17), social support (OR = 0.54; 95% CI = 0.35 to 0.83), and NYHA classification 
      (OR = 1.70; 95% CI = 1.05 to 2.77) independently predicted distress at follow up. 
      High social support contributed to a resolution of anxiety or depression, while 
      partnership and low levels of emotional problems protected patients who began the 
      study in a good emotional state from psychological distress. CONCLUSION: In 
      everyday practice it is important to consider that a high NYHA classification and 
      emotional problems may contribute to anxiety or depression, while high social 
      support and living in a relationship may positively influence the psychological 
      health of patients with heart failure.
FAU - Scherer, Martin
AU  - Scherer M
AD  - Department of General Practice, Georg-August-University of Gottingen, Germany. 
      mschere@gwdg.de
FAU - Himmel, Wolfgang
AU  - Himmel W
FAU - Stanske, Beate
AU  - Stanske B
FAU - Scherer, Franziska
AU  - Scherer F
FAU - Koschack, Janka
AU  - Koschack J
FAU - Kochen, Michael M
AU  - Kochen MM
FAU - Herrmann-Lingen, Christoph
AU  - Herrmann-Lingen C
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Br J Gen Pract
JT  - The British journal of general practice : the journal of the Royal College of 
      General Practitioners
JID - 9005323
SB  - IM
MH  - Adaptation, Psychological
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anxiety Disorders/diagnosis/*etiology
MH  - Depressive Disorder/diagnosis/*etiology
MH  - Epidemiologic Methods
MH  - *Family Practice
MH  - Female
MH  - Germany
MH  - Heart Failure/*psychology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Psychiatric Status Rating Scales
MH  - Quality of Life
MH  - Social Support
MH  - Surveys and Questionnaires
PMC - PMC2151812
EDAT- 2007/10/11 09:00
MHDA- 2008/03/06 09:00
PMCR- 2008/10/01
CRDT- 2007/10/11 09:00
PHST- 2007/10/11 09:00 [pubmed]
PHST- 2008/03/06 09:00 [medline]
PHST- 2007/10/11 09:00 [entrez]
PHST- 2008/10/01 00:00 [pmc-release]
PST - ppublish
SO  - Br J Gen Pract. 2007 Oct;57(543):801-7.