Abstract 5635: Negative Thinking: A Modifiable Target for the Treatment of Depressive Symptoms in Patients with Heart Failure
Background: The adverse effects of depressive symptoms on mortality and morbidity in patients with HF have been well described. The next step is to identify modifiable predictors of depressive symptoms that can be targeted for intervention. Negative thinking, a process of self-critical cognition, has been associated with depressed mood, which suggests it may be a modifiable target for intervention. However, it is not known whether negative thinking is independently related to depressive symptoms in patients with HF.
To describe the level of negative thinking among patients with HF.
To determine whether negative thinking is a predictor of depressive symptoms in patients with HF.
Methods: In this cross-sectional, descriptive study, 154 patients (61±12 years, 31% female, 52% NYHA Class III/IV) were recruited from an outpatient HF clinic. Negative thinking was measured with the Crandell Cognitions Inventory. Depressive symptoms were measured using the Beck Depression Inventory-II (BDI). Multiple linear regression was used to determine whether negative thinking is an independent predictor of depressive symptoms.
Results: The mean level of negative thinking was 60 ± 26, which is higher than the reported mean of 45 ± 8 for non-depressed, normal controls. The prevalence of clinically significant depressive symptoms (BDI >13) was 33%. Patients with depressive symptoms had substantially higher levels of negative thinking compared to patients without depressive symptoms (83 ± 27 vs. 49 ± 17, p <.001). Negative thinking independently predicted depressive symptoms (β = 0.21, p < .001, 95% CI = .17–.25) after controlling for age, gender, marital status, ejection fraction, NYHA functional class, and ACE inhibitor use. Negative thinking alone explained 38% of the variance in depressive symptoms.
Conclusion: Our findings suggest that negative thinking plays a major role in the manifestation of depressive symptoms in patients with HF. Interventions that target the reduction of negative thinking may reduce depressive symptoms in patients with HF.