HF diagnosis heightens depression, suicide risk in men, women
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Both men and women with HF faced higher risks for depression and death by suicide in the first 3 months after their diagnosis, researchers reported in JACC: Heart Failure.
“The large burden of disease associated with HF may potentially cause psychosocial distress that worsens suffering, quality of life and long-term health outcomes,” Casey Crump, MD, PhD, vice chair for research in the department of family medicine and community health at Mount Sinai, and colleagues wrote. “Previous evidence has shown that HF patients with psychosocial distress are more likely to struggle with HF self-care, resulting in higher hospitalization rates.”
In a large national cohort study, Crump and colleagues evaluated 154,572 individuals in Sweden who were diagnosed with HF between 2002 and 2017 (mean age, 65 years) to observe risks for new-onset major depression and suicide. Researchers also sought information regarding time periods of heightened risk and sex-specific differences.
Nationwide inpatient, outpatient and death records were used to find cases of depression and suicide. Researchers compared the patients with HF with 1,545,720 age- and sex-matched population-based controls.
Mean follow-up time was 13.8 years.
During the study period, new-onset major depression occurred in 13.2% of the HF group and 9.7% of the control group, whereas suicide occurred in 0.3% of the HF group and 0.2% of the control group, according to the researchers.
Researchers found that both men and women diagnosed with HF faced increased risks for major depression and suicide compared with controls. The highest risks occurred in first 3 months after diagnosis (adjusted incidence rate ratio [IRR] for major depression in men = 3.34; 95% CI, 3.04-3.68; aIRR for major depression in women = 2.78; 95% CI, 2.51-3.09; aIRR for suicide in men = 4.47; 95% CI, 2.62-7.62; aIRR for suicide in women = 2.82; 95% CI, 1.11-7.12), but after 12 months, the risks declined to modestly or no increased risks, according to the study.
Compared with men, an HF diagnosis in women was related to significantly more instances of depression in the first 3 months, according to the study. The findings were consistent regardless of age.
“Our findings underscore the importance of screening for depression and suicidality in patients with HF,” Crump and colleagues wrote. “Patients with positive screening need prompt psychiatric treatment, followed by close monitoring for adherence with treatment for both their mental and their cardiovascular health.”
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