Abstract 18172: Gender Counts: Depressive Symptoms in Women and Men with Heart Failure
Despite adverse effects of depressive symptoms in heart failure (HF), little is known about gender differences in depressive symptoms or their correlates. The aims of this study were to 1) compare rates of depressive symptoms in men and women with HF, and 2) identify gender-specific differences in demographics, behavioral, clinical, and psychosocial factors related to depression.
Methods: A sample of 622 HF patients (70% male, 61±13 years, 59 % NYHA Class III/IV), from The HF Quality of Life Trialists Collaborative Registry was used. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ9), using the published cut point of 10, and stratified by gender. Measures of factors potentially associated with depression were: demographics (age, gender, ethnicity, education, marital status and financial status); behavioral factors (self-reported smoking and exercise); clinical characteristics (BMI, HF etiology, NYHA class and Charlson Comorbidity index); psychosocial factors (functional capacity [Duke Activity Status Index], anxiety [Brief Symptom Inventory] and perceived control [Control Attitudes Scale-Revised]). Hierarchical logistic regression was used to determine factors independently associated with depressive symptoms. Separate models were built for women and men.
Results: Compared to men with HF, women with HF had higher levels of depressive symptoms (7.0 ± 5.9 vs. 8.6 ± 6.3, p =.003). Independent predictors of depressive symptoms for men were financial status (β =.087, p = .027), NYHA class (β = .38, p =.001), functional status (β = -0.159, p <.001), health perception (β = .86, p =.043), perceived control (β = -0.120, p = .002) and anxiety (β = .423, p<.001). Independent predictors for women were BMI (β =.118, p =.037), perceived control (β = -0.147, p =.013) and anxiety (β = .539, p <.001).
Conclusions: When designing interventions for depressive symptoms in HF patients, gender counts. For women, clinicians should consider programs that focus on evaluating perceptions of body weight and improving functional status. For men, the focus should be on improving perceived functional status. Both men and women with HF are likely to benefit from programs that reduce anxiety and foster patient autonomy and control in decision-making.
- © 2010 by American Heart Association, Inc.