Depressive symptoms in outpatients with heart failure

Importance of inflammatory biomarkers, disease severity and personality

C.J. Brouwers, N. Kupper, A.J.M. Pelle, B.M. Szabó, B.L.W.J.J.M. Westerhuis, J. Denollet

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective: 
Depressive symptoms are highly prevalent in heart failure (HF) patients, however the underlying etiology of depression in HF patients remains yet unclear. Hence, the goal is to examine the relative importance of inflammation, disease severity and personality as predictors of depression in HF patients. 
Design: 
Depressive symptoms (Hospital Anxiety and Depression Scale, depression subscale) were assessed at baseline and one-year follow-up in 268 HF patients (75.6% men; mean age = 66.7 ± 8.7). Markers of inflammation (TNFα, sTNFr1, sTNFr2, IL-6 and IL-10), disease severity (e.g. New York Heart Association (NYHA) classification) and personality (Type D personality, loneliness) were assessed at baseline. 
Results: 
At baseline, NYHA class, body mass index, educational level, Type D personality and loneliness were significantly associated with depression. Higher NYHA class (B = 2.25; SE = .83), higher educational level (B = 1.41; SE = .48), Type D personality (B = 2.56; SE = .60) and loneliness (B = .19; SE = .05) were also independently associated with higher depression levels at one-year follow-up (all p-values < .005). Inflammation, brain natriuretic peptide and left ventricular ejection fraction were not related to depression over time. 
Conclusions: 
Personality factors, but not inflammation, were independent concomitants of depressive symptoms in patients with HF. Gaining more insight into the etiology of depression in HF patients is important in order to identify potential targets for novel interventions.Keywords: depression, heart failure, inflammation, disease severity, personality, predictive theoretical models
Original languageEnglish
Pages (from-to)564-582
JournalPsychology & Health
Volume29
Issue number5
DOIs
Publication statusPublished - 2014

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Outpatients
Depression
Loneliness
Brain Natriuretic Peptide
Interleukin-10
Interleukin-6
Body Mass Index
Theoretical Models

Cite this

Brouwers, C.J. ; Kupper, N. ; Pelle, A.J.M. ; Szabó, B.M. ; Westerhuis, B.L.W.J.J.M. ; Denollet, J. / Depressive symptoms in outpatients with heart failure : Importance of inflammatory biomarkers, disease severity and personality. In: Psychology & Health. 2014 ; Vol. 29, No. 5. pp. 564-582.
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abstract = "Objective: Depressive symptoms are highly prevalent in heart failure (HF) patients, however the underlying etiology of depression in HF patients remains yet unclear. Hence, the goal is to examine the relative importance of inflammation, disease severity and personality as predictors of depression in HF patients. Design: Depressive symptoms (Hospital Anxiety and Depression Scale, depression subscale) were assessed at baseline and one-year follow-up in 268 HF patients (75.6{\%} men; mean age = 66.7 ± 8.7). Markers of inflammation (TNFα, sTNFr1, sTNFr2, IL-6 and IL-10), disease severity (e.g. New York Heart Association (NYHA) classification) and personality (Type D personality, loneliness) were assessed at baseline. Results: At baseline, NYHA class, body mass index, educational level, Type D personality and loneliness were significantly associated with depression. Higher NYHA class (B = 2.25; SE = .83), higher educational level (B = 1.41; SE = .48), Type D personality (B = 2.56; SE = .60) and loneliness (B = .19; SE = .05) were also independently associated with higher depression levels at one-year follow-up (all p-values < .005). Inflammation, brain natriuretic peptide and left ventricular ejection fraction were not related to depression over time. Conclusions: Personality factors, but not inflammation, were independent concomitants of depressive symptoms in patients with HF. Gaining more insight into the etiology of depression in HF patients is important in order to identify potential targets for novel interventions.Keywords: depression, heart failure, inflammation, disease severity, personality, predictive theoretical models",
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Depressive symptoms in outpatients with heart failure : Importance of inflammatory biomarkers, disease severity and personality. / Brouwers, C.J.; Kupper, N.; Pelle, A.J.M.; Szabó, B.M.; Westerhuis, B.L.W.J.J.M.; Denollet, J.

In: Psychology & Health, Vol. 29, No. 5, 2014, p. 564-582.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Depressive symptoms in outpatients with heart failure

T2 - Importance of inflammatory biomarkers, disease severity and personality

AU - Brouwers, C.J.

AU - Kupper, N.

AU - Pelle, A.J.M.

AU - Szabó, B.M.

AU - Westerhuis, B.L.W.J.J.M.

AU - Denollet, J.

PY - 2014

Y1 - 2014

N2 - Objective: Depressive symptoms are highly prevalent in heart failure (HF) patients, however the underlying etiology of depression in HF patients remains yet unclear. Hence, the goal is to examine the relative importance of inflammation, disease severity and personality as predictors of depression in HF patients. Design: Depressive symptoms (Hospital Anxiety and Depression Scale, depression subscale) were assessed at baseline and one-year follow-up in 268 HF patients (75.6% men; mean age = 66.7 ± 8.7). Markers of inflammation (TNFα, sTNFr1, sTNFr2, IL-6 and IL-10), disease severity (e.g. New York Heart Association (NYHA) classification) and personality (Type D personality, loneliness) were assessed at baseline. Results: At baseline, NYHA class, body mass index, educational level, Type D personality and loneliness were significantly associated with depression. Higher NYHA class (B = 2.25; SE = .83), higher educational level (B = 1.41; SE = .48), Type D personality (B = 2.56; SE = .60) and loneliness (B = .19; SE = .05) were also independently associated with higher depression levels at one-year follow-up (all p-values < .005). Inflammation, brain natriuretic peptide and left ventricular ejection fraction were not related to depression over time. Conclusions: Personality factors, but not inflammation, were independent concomitants of depressive symptoms in patients with HF. Gaining more insight into the etiology of depression in HF patients is important in order to identify potential targets for novel interventions.Keywords: depression, heart failure, inflammation, disease severity, personality, predictive theoretical models

AB - Objective: Depressive symptoms are highly prevalent in heart failure (HF) patients, however the underlying etiology of depression in HF patients remains yet unclear. Hence, the goal is to examine the relative importance of inflammation, disease severity and personality as predictors of depression in HF patients. Design: Depressive symptoms (Hospital Anxiety and Depression Scale, depression subscale) were assessed at baseline and one-year follow-up in 268 HF patients (75.6% men; mean age = 66.7 ± 8.7). Markers of inflammation (TNFα, sTNFr1, sTNFr2, IL-6 and IL-10), disease severity (e.g. New York Heart Association (NYHA) classification) and personality (Type D personality, loneliness) were assessed at baseline. Results: At baseline, NYHA class, body mass index, educational level, Type D personality and loneliness were significantly associated with depression. Higher NYHA class (B = 2.25; SE = .83), higher educational level (B = 1.41; SE = .48), Type D personality (B = 2.56; SE = .60) and loneliness (B = .19; SE = .05) were also independently associated with higher depression levels at one-year follow-up (all p-values < .005). Inflammation, brain natriuretic peptide and left ventricular ejection fraction were not related to depression over time. Conclusions: Personality factors, but not inflammation, were independent concomitants of depressive symptoms in patients with HF. Gaining more insight into the etiology of depression in HF patients is important in order to identify potential targets for novel interventions.Keywords: depression, heart failure, inflammation, disease severity, personality, predictive theoretical models

U2 - 10.1080/08870446.2013.869813

DO - 10.1080/08870446.2013.869813

M3 - Article

VL - 29

SP - 564

EP - 582

JO - Psychology & Health: Official journal of the European Health Psychology Society (EHPS)

JF - Psychology & Health: Official journal of the European Health Psychology Society (EHPS)

SN - 0887-0446

IS - 5

ER -