Controlling depression is associated with improved health for heart-failure patients
(Medical Xpress)—Controlling depression in patients with heart failure can improve health status, social functioning and quality of life, according to a new study by psychiatrists and cardiologists at the UC Davis and Duke University schools of medicine.
While depression is known to worsen a variety of diseases, the current study is one of the first to show that reducing symptoms of the mental health condition can benefit physical health. The study is available online now and will be distributed in the print issue of Circulation: Heart Failure on Nov. 20.
"The improved endurance measurements were especially striking," said study lead author Glen Xiong, associate clinical professor of psychiatry and behavioral sciences at UC Davis. "I think clinicians will be more motivated to both screen and treat depressive symptoms in people with heart failure because of the significant functional improvements."
Heart failure causes the heart's pumping action to become progressively weak and, even with advanced treatments, is associated with increased disability and mortality. The estimated direct and indirect costs of the disease in the U.S. are more than $37 billion. It affects more than 5 million Americans, about 20 percent of whom are also diagnosed with depression.
For the study, Xiong and his colleagues conducted a secondary analysis on data obtained from the 2008 Sertraline Against Depression and Heart Disease in Chronic Heart Failure (SADHART-CHF) study. This multi-center clinical trial evaluated the efficacy of the antidepressant medication sertraline in reducing depressive and cardiac symptoms among 469 men and women 45 years of age or older with both heart failure and major depressive disorder.
Sertraline is from a class of medications called selective serotonin reuptake inhibitors that can help balance brain chemicals linked with panic disorder and depression. The initial SADHART-CHF results found that sertraline treatment, however, did not significantly differ from placebo in reducing depressive symptoms.
The current study focused on participants' depression and health status, independent of sertraline.
"We wanted to dig deeper into the health effects in patients whose depression improved over the study period, regardless of their medication use," said Xiong.
Xiong and the research team used data from rigorous, standardized evaluations administered over the course of the 12-week SADHART-CHF study to measure both depression and general health. The Hamilton Depression Rating Scale questionnaire was administered periodically to all study participants to assess the severity of depressive symptoms. Cardiac and general health were determined using the Kansas City Cardiomyopathy Questionnaire and the Short Form Health Survey (completed by 285 study participants) and a six-minute walk test (completed by 378 participants).
Participants whose depression remitted during the trial intervention had improvement on scores of physical health on a variety of measures, including social limitation, physical limitation, quality of life, symptom frequency and total symptoms.
"To put the results in perspective, a five-point change in the Kansas City Cardiomyopathy Questionnaire is clinically significant," says Xiong. "The patients whose depression was in remission had scores 13 points higher than those who were not in remission."
Those outcomes were backed up by the Short Form Health Survey, which showed that reduced depression symptoms also improved physical function and general health perception. The six-minute walk test also showed significant improvements in endurance, as patients with reduced depression could walk on average 47 meters—or about 154 feet—farther than their counterparts with major depression.
According to the researchers, their results open up a new avenue of investigation that could lead to therapies that leverage the connections between the mind and the body and help heart-failure patients stabilize their condition.
"Our new study is just the tip of the iceberg, since the relationship between the body and mind is extremely complex," said Wei Jiang, senior author of the study and director of the Neuropsychocardiology Laboratory at Duke University Medical Center.
"Researchers and practitioners increasingly recognize that the mind and the body have powerful connections, which is promising since they have been segregated for years," Jiang added. "This kind of interdisciplinary research can help find answers to how physical health affects mental health, and vice versa, and inform the development of clinical practices that recognize this approach."
Xiong and Jiang also recommend further research to delineate why some patients respond to depression medications while others do not.
"There may be underlying genetic or other physiological differences, such as inflammatory markers, that alter the opportunities for treatments to work optimally," said Xiong. "Knowing that relieving depression can be accompanied by broad physical health benefits, we want to be able to identify ways to make treatment modalities as helpful as possible for as many people as possible, especially for those with serious heart disease."
Provided by UC Davis
- Link between depression, higher risk of cardio events may be because of change in health behaviors Nov 25, 2008 | not rated yet | 0
- Heart failure patients may suffer similarly to advanced cancer patients May 02, 2008 | not rated yet | 0
- Exercise boosts mental and physical health of heart failure patients Jul 31, 2012 | not rated yet | 0
- Exercise plus psychological counseling may benefit depressed heart failure patients May 04, 2008 | not rated yet | 0
- More white blood cells in cardiac patients with depression Sep 06, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
Marie Curie's leukemia
May 13, 2013 Does anyone know what might be the cause of Marie Curie's cancer
- More from Physics Forums - Medical Sciences
More news stories
Patients with treatment-resistant major depression saw dramatic improvement in their illness after treatment with ketamine, an anesthetic, according to the largest ketamine clinical trial to-date led by researchers from the ...
Psychology & Psychiatry 12 hours ago | 4.7 / 5 (3) | 0 |
The latest makeover to a massive psychiatric tome honored by some, reviled by others and even called the "Bible" of mental disorders is being released Saturday with a host of new changes.
Psychology & Psychiatry May 18, 2013 | not rated yet | 1
(HealthDay)—Most Medicare beneficiaries treated in inpatient psychiatric facilities (IPFs) exhibit characteristics associated with hospital readmission, according to a report prepared for the National Association ...
Psychology & Psychiatry May 17, 2013 | not rated yet | 0
Skydivers show the same level of physical stress before every jump whether a first-timer or experienced jumper, say Northumbria researchers.
Psychology & Psychiatry May 17, 2013 | not rated yet | 0 |
Children of depressed parents pick up on their parents' sadness—whether mom or dad realizes their mood or not.
Psychology & Psychiatry May 17, 2013 | 4.5 / 5 (2) | 1 |
Researchers at the University of Wisconsin have identified a potential new risk factor for obstructive sleep apnea: asthma. Using data from the National Institutes of Health (Heart, Lung, and Blood Institute)-funded Wisconsin ...
21 minutes ago | not rated yet | 0 |
A new study looking at sleep-disordered breathing (SDB) and markers for Alzheimer's disease (AD) risk in cerebrospinal fluid (CSF) and neuroimaging adds to the growing body of research linking the two.
31 minutes ago | not rated yet | 0 |
Gourmands and foodies everywhere have long recognized ginger as a great way to add a little peppery zing to both sweet and savory dishes; now, a study from researchers at Columbia University shows purified components of the ...
21 minutes ago | not rated yet | 0
In their quest to learn more about the variability of cells between and within tissues, biomedical scientists have devised tools capable of simultaneously measuring dozens of characteristics of individual ...
1 hour ago | not rated yet | 0 |
Scientists at Johns Hopkins have turned their view of osteoarthritis (OA) inside out. Literally. Instead of seeing the painful degenerative disease as a problem primarily of the cartilage that cushions joints, ...
1 hour ago | 5 / 5 (1) | 0 |
The hunt for an HIV vaccine has gobbled up $8 billion in the past decade, and the failure of the most recent efficacy trial has delivered yet another setback to 26 years of efforts.
5 hours ago | not rated yet | 0