Somatic versus cognitive symptoms of depression as predictors of all-cause mortality and health status in chronic heart failure
Abstract
OBJECTIVE: Depression is a predictor of adverse health outcomes in chronic heart failure (CHF), but it is not known whether specific symptoms drive this relationship. We examined the impact of somatic/affective, cognitive/affective, and total depressive symptoms on all-cause mortality and health status in CHF. METHOD: Consecutive CHF outpatients (n = 366) completed the Beck Depression Inventory. The primary endpoint was all-cause mortality; the secondary endpoint was disease-specific health status, as measured by the Minnesota Living with Heart Failure Questionnaire (n = 285) at inclusion and 1-year follow-up. The study was conducted between October 2003 and March 2007. RESULTS: There were 68 (18.6%) deaths (mean +/- SD follow-up, 37.2 +/- 10.6 months). Patients high on somatic/affective depressive symptoms had a greater incidence of mortality compared to patients low on somatic/affective depressive symptoms (31% vs 15%; hazard ratio [HR] = 2.3; 95% CI, 1.38-3.69; P = .001). There was no significant difference in the incidence of mortality between patients high versus low on cognitive/affective depressive symptoms (23% vs 18%; HR = 1.4; 95% CI, 0.80-2.40; P = .25), but there was a significant difference between patients high versus low on total depressive symptoms (24% vs 16%; HR = 1.6; 95% CI, 1.01-2.63; P < .05). After adjusting for demographic and clinical characteristics, we found that somatic/affective depressive symptoms predicted all-cause mortality (HR = 1.8; 95% CI, 1.03-3.07; P = .04), while cognitive/affective and total depressive symptoms did not. Both dimensions of depressive symptoms predicted disease-specific health status at 1 year. CONCLUSIONS: Only somatic/affective depressive symptoms significantly predicted all-cause mortality in CHF. In the context of diagnosing and intervening, awareness of subtypes of depressive symptoms is important.
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In patients with myocardial infarction or chronic heart failure, somatic/affective symptoms of depression are more predictive of overall mortality than cognitive/affective symptoms of depression.
“Indeed, several recently published papers even suggest that (in patients with myocardial infarction or with chronic heart failure) the so-called somatic/affective symptoms of depression are more predictive of overall mortality than the cognitive/affective symptoms of depression (De Jonge et al., 2006; Schiffer et al., 2009).”
From Presence and predictors of pain in depression: Results from the FINDER study (2010) · cites this paper as Schiffer et al., 2009
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“Many previous studies also revealed that somatic symptoms are prospectively associated with cardiac prognosis among patients with myocardial infarction, 23 stable CHD, 24 congestive heart failure 25 or other cardiovascular diseases.”
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Treating Depression with Ultrasound: An Exploratory Study
Guo, H. (2016) · ERA: Education and Research Archive (University of Alberta) · doi:10.7939/r37d2qq01 · Cited by 1 · see citing works
Relation Between Depression Symptoms and Suicide Risk in Adults and Older Adults
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“It has been observed that both major and minor depression affect the clinical outcomes of patients with HF (35, 65-69).”
BackgroundKawilapat, S., Traisathit, P., Maneeton, N., Prasitwattanaseree, S., Kongsuk, T., Arunpongpaisal, S., Leejongpermpoon, J., Sukhawaha, S., & Maneeton, B. (2024) · Behavioral Sciences · doi:10.3390/bs14070577
“In a study of patients with chronic heart disease [19], the authors reported that patients with high scores for somatic/affective depressive symptoms had a higher incidence of mortality.”
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Depressive symptom heterogeneity and mortality in a prospective U.S. cohort
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The Relationship Between Perceived Social Status, Stress, and Health in Mexican American Immigrants
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- Authors
- Schiffer, A. A., Pelle, A. J., Smith, O. R. F., Widdershoven, J. W., Hendriks, E. H., & Pedersen, S. S.
- Affiliations
- Elisabeth-TweeSteden Ziekenhuis (NL)
- Corresponding author
- Schiffer, Angélique A.
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2009-07-28
- Volume
- 70
- Issue
- 12
- Pages
- 1667-1673
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2123514917
- Cited by
- 87
- References
- 0
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 3 · 2023: 1 · 2022: 3 · 2020: 5 · 2019: 3 · 2018: 5 · 2017: 5 · 2016: 5 · 2015: 7 · 2014: 7 · 2013: 6 · 2012: 9
- FWCI
- 6.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (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 › Clinical Psychology › Health and Well-being Studies
- Keywords
- depression, chronic heart failure, somatic depressive symptoms, all-cause mortality, health status, Minnesota Living with Heart Failure Questionnaire, Beck Depression Inventory
- MeSH terms
- Aged, 80 and over, Cause of Death, Chronic Disease, Cognition Disorders, Depression, Female, Follow-Up Studies, Health Status, Heart Failure, Humans, Longitudinal Studies, Male, Personality Inventory, Prognosis, Psychometrics, Surveys and Questionnaires, Risk Factors, Somatoform Disorders, Comorbidity, Prevalence, Kaplan-Meier Estimate
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