Depression in heart failure: can PHQ-9 help?
Abstract
Background The Patient Health Questionnaire 9 (PHQ-9) is an effective tool for identification and grading of depression symptoms. Data on PHQ-9 utility for patients with heart failure (HF) are limited.Methods We evaluated the severity of depression by PHQ-9 at baseline and its association with health care resource utilization (HCRU) rates and quality of life (QoL) in 308 outpatients enrolled in a prospective HF cohort study. Depression symptoms were stratified according to PHQ-9 score as minimal (0-4), mild (5-9), or moderate-to-severe (10-27).Results Mean age of patients was 57±11years; 65% were men; 50% were white and 47% black; ejection fraction was 30±15%. Over 24±12months (total: 625person-years), there were 41 (13.3%) major clinical events (34 deaths, 5 transplants, 2 ventricular assist device implantations), 633 all-cause admissions (249 [39.3%] for HF), and 362 emergency department (ED) visits. Moderate-to-severe depressive symptoms were associated with 70% more all-cause admissions compared to patients without depressive symptoms and 2.5 times more HF-related admissions. However, less than 50% of patients with moderate-to-severe symptoms were on antidepressants. In adjusted analyses, even mild depressive symptoms were associated with 57% more all-cause admissions compared to patients without depressive symptoms and more than 2-fold higher rate of HF-related admissions. Depressive symptoms were not associated with ED visits. Increasing PHQ-9 score was associated with progressively worse QoL. PHQ-9 was not associated with major clinical events.Conclusions PHQ-9 effectively identifies HF patients at risk for increased HCRU and lower QoL. Interventions to reduce depression symptoms may help improve HF outcomes.
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Only the Patient Health Questionnaire-9 has been shown to correlate with quality of life and readmission in CHF.
“Only the Patient Health Questionnaire‐9 has been shown to correlate with QoL and readmission in CHF. 103 , 104”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [103]
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- Authors
- Bhatt, K. N., Kalogeropoulos, A. P., Dunbar, S. B., Butler, J., & Georgiopoulou, V. V.
- Affiliations
- Emory University (US)
- Stony Brook University (US)
- Corresponding author
- Georgiopoulou, Vasiliki V.
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 221
- Pages
- 246-250
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2467869403
- Cited by
- 64
- References
- 30
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 11 · 2021: 10 · 2020: 16 · 2019: 5 · 2018: 1 · 2017: 3 · 2016: 1
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression, heart failure, PHQ-9, depression screening, healthcare resource utilization, hospitalization, quality of life, antidepressant use, depression severity, emergency department visits
- MeSH terms
- Adult, Aged, Depression, Female, Follow-Up Studies, Health Surveys, Heart Failure, Humans, Male, Middle Aged, Prospective Studies, Cohort Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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