Mental health illnesses are associated with frequent hospitalisation and an increased risk of all-cause mortality. Despite the high prevalence of depression in patients with chronic heart failure (CHF), there is a paucity of data on this subject from low and middle-income countries (LMIC). The aim of this study was to determine the prevalence of depression, anxiety, and stress symptoms in patients attending a dedicated CHF clinic. A prospective study was conducted at an outpatient heart failure clinic in a tertiary academic centre. The study participants completed a Depression, Anxiety and Stress (DASS-21) questionnaire to screen for the presence and severity of depression, anxiety and stress symptoms. Furthermore, the Minnesota Living with Heart Failure Questionnaire (MLHFQ) was completed and used to evaluate the impact of CHF on health-related quality of life (QoL). Descriptive statistics were used to describe patients' characteristics and logistic regression analysis to identify predictors of symptoms of depression. The study population comprised of 103 patients, predominantly female (62.1%) with a median age of 53 (interquartile range 38–61) years. Symptoms of depression were reported by 52.4%, with 11.6% reporting symptoms suggestive of extremely severe depression. Anxiety was diagnosed in 53.4% of patients and extremely severe anxiety was reported by 18.4% of patients. Fifty patients were classified as stressed, and only 7.7% had extremely severe stress. More than half of the patients (54.4%) were in New York Heart Association functional class I. The mean left ventricular ejection fraction in the entire cohort was 30% (SD = ± 11.1%). In the multivariable logistic regression model, the MLHFQ score [odds ratio (OR) 1.04, 95% CI:1.02–1.06, p = 0.001] and the six-minute walk test [OR 0.99, 95% CI: 0.98–0.99, p = 0.014] were identified as independent predictors of depression. Depression and anxiety symptoms were found in over half of patients attending the CHF clinic. We recommend that mental health screening should be routinely performed in patients with CHF. Prospective, adequately powered, multicentre studies from LMIC investigating the impact of depression, anxiety and stress on CHF outcomes such as health-related QoL, hospitalisation and mortality are required.

中文翻译：

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慢性心力衰竭患者抑郁，压力和焦虑症状的患病率

心理健康疾病与经常住院和全因死亡率增加的风险有关。尽管患有慢性心力衰竭（CHF）的抑郁症患病率很高，但来自中低收入国家（LMIC）的有关该主题的数据很少。这项研究的目的是确定在专门的CHF诊所就诊的患者中抑郁，焦虑和压力症状的患病率。在三级学术中心的门诊心力衰竭诊所进行了一项前瞻性研究。研究参与者完成了抑郁，焦虑和压力（DASS-21）调查表，以筛选抑郁，焦虑和压力症状的存在和严重程度。此外，明尼苏达州心衰患者生活调查问卷（MLHFQ）已完成，用于评估CHF对健康相关生活质量（QoL）的影响。描述性统计数据用于描述患者的特征，并进行逻辑回归分析以鉴定抑郁症状的预测因子。研究人群包括103例患者，主要为女性（62.1％），中位年龄为53岁（四分位间距为38-61岁）。抑郁症状的报告率为52.4％，其中11.6％的症状表明患有严重的抑郁症。在53.4％的患者中诊断出焦虑，而在报告中有18.4％的患者报告出严重的焦虑。50名患者被归类为压力，只有7.7％的患者患有极度严重的压力。超过一半的患者（54.4％）属于纽约心脏协会功能I级。整个队列的平均左心室射血分数为30％（SD =±11.1％）。在多变量logistic回归模型中，MLHFQ得分[比值比（OR）1.04，95％CI：1.02-1.06，p = 0.001]和六分钟步行测试[OR 0.99，95％CI：0.98-0.99，p = 0.014]被确定为抑郁症的独立预测因子。在CHF诊所的一半以上患者中发现了抑郁和焦虑症状。我们建议对CHF患者应常规进行精神健康筛查。来自LMIC的前瞻性，有足够能力的多中心研究需要调查抑郁症，焦虑症和压力对CHF结果的影响，例如与健康相关的QoL，住院和死亡率。在多变量logistic回归模型中，MLHFQ得分[比值比（OR）1.04，95％CI：1.02-1.06，p = 0.001]和六分钟步行测试[OR 0.99，95％CI：0.98-0.99，p = 0.014]被确定为抑郁症的独立预测因子。在CHF诊所的一半以上患者中发现了抑郁和焦虑症状。我们建议对CHF患者应常规进行精神健康筛查。来自LMIC的前瞻性，有足够能力的多中心研究需要调查抑郁症，焦虑症和压力对CHF结果的影响，例如与健康相关的QoL，住院和死亡率。在多变量logistic回归模型中，MLHFQ得分[比值比（OR）1.04，95％CI：1.02-1.06，p = 0.001]和六分钟步行测试[OR 0.99，95％CI：0.98-0.99，p = 0.014]被确定为抑郁症的独立预测因子。在CHF诊所的一半以上患者中发现了抑郁和焦虑症状。我们建议对CHF患者应常规进行精神健康筛查。来自LMIC的前瞻性，有足够能力的多中心研究需要调查抑郁症，焦虑症和压力对CHF结果的影响，例如与健康相关的QoL，住院和死亡率。在CHF诊所的一半以上患者中发现了抑郁和焦虑症状。我们建议对CHF患者应常规进行精神健康筛查。来自LMIC的前瞻性，有足够能力的多中心研究需要调查抑郁症，焦虑症和压力对CHF结果的影响，例如与健康相关的QoL，住院和死亡率。在CHF诊所的一半以上患者中发现了抑郁和焦虑症状。我们建议对CHF患者应常规进行精神健康筛查。来自LMIC的前瞻性，有足够能力的多中心研究需要调查抑郁症，焦虑症和压力对CHF结果的影响，例如与健康相关的QoL，住院和死亡率。