scholarly journals The prevalence of depression, stress and anxiety symptoms in patients with chronic heart failure 

2020 ◽  
Author(s):  
Nqoba Tsabedze ◽  
Jamie-Leigh Kinsey ◽  
Dineo Mpanya ◽  
Vanessa Mogashoa ◽  
Eric Klug ◽  
...  
Keyword(s):  
Mental Health ◽  
Heart Failure ◽  
Logistic Regression ◽  
Chronic Heart Failure ◽  
Anxiety Symptoms ◽  
Symptoms Of Depression ◽  
Heart Failure Clinic ◽  
Stress Symptoms ◽  
Prevalence Of Depression ◽  
The Impact

Abstract Background: Mental health illnesses are associated with frequent rehospitalisation 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). This study aimed to determine the prevalence of depression, anxiety and stress symptoms in patients attending a dedicated chronic heart failure clinic. Methods: 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. Descriptive statistics were used to describe patients' characteristics and logistic regression analysis to identify predictors of symptoms of depression.Results: 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 11.7% reporting symptoms suggestive of extremely severe depression. Anxiety was diagnosed in 53.4% of patients and extremely severe anxiety 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 (NYHA) functional class I with a mean (SD) left ventricular ejection fraction (LVEF) of 30.5% (11.1). In the multivariable logistic regression model, permanent employment [odds ratio (OR) -1.22, 95% CI:-0.01– -0.00, p=0.012], the six-minute walk test [OR -0.07, 95% CI: 0.02 – 0.06, p=0.001] and orthopnoea [OR 1.89, 95% CI: -0.01 – -0.00, p=0.012] were identified as independent predictors of depression.Conclusion: Depression and anxiety symptoms were found in over half of patients attending the chronic heart failure clinic. We recommend that mental health screening should be routinely performed in patients with chronic heart failure. Prospective, adequately powered, multicentre studies from LMIC investigating the impact of depression, anxiety and stress on CHF hospitalisation and mortality are required.

scholarly journals The prevalence of depression, stress and anxiety symptoms in patients with chronic heart failure

2021 ◽  
Author(s):  
Nqoba Tsabedze ◽  
Jamie-Leigh Kinsey ◽  
Dineo Mpanya ◽  
Vanessa Mogashoa ◽  
Eric Klug ◽  
...  
Keyword(s):  
Mental Health ◽  
Heart Failure ◽  
Logistic Regression ◽  
Chronic Heart Failure ◽  
Anxiety Symptoms ◽  
Symptoms Of Depression ◽  
Stress Symptoms ◽  
Prevalence Of Depression ◽  
Health Related ◽  
The Impact

Abstract Background: 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. Methods: 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 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. Results: 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 11.7% 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 30.5 (SD =±11.1%). In the multivariable logistic regression model, permanent employment [odds ratio (OR) -1.22, 95% CI:-0.01– -0.00, p=0.012], the six-minute walk test [OR -0.07, 95% CI: 0.02 – 0.06, p=0.001] and orthopnoea [OR 1.89, 95% CI: -0.01 – -0.00, p=0.012] were identified as independent predictors of depression. Conclusion: 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.

scholarly journals The prevalence of depression, stress and anxiety symptoms in patients with chronic heart failure

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nqoba Tsabedze ◽  
Jamie-Leigh Hayes Kinsey ◽  
Dineo Mpanya ◽  
Vanessa Mogashoa ◽  
Eric Klug ◽  
...  
Keyword(s):  
Mental Health ◽  
Heart Failure ◽  
Logistic Regression ◽  
Chronic Heart Failure ◽  
Anxiety Symptoms ◽  
Symptoms Of Depression ◽  
Stress Symptoms ◽  
Prevalence Of Depression ◽  
Health Related ◽  
The Impact

Abstract Background 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. Methods 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. Results 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. Conclusion 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.

The Prevalence of depression in outpatients attending a chronic heart failure with reduced ejection fraction clinic in a tertiary academic centre in Johannesburg, South Africa

2020 ◽  
Author(s):  
Nqoba Tsabedze ◽  
Jamie-Leigh Kinsey ◽  
Dineo Mpanya ◽  
Vanessa Mogashoa ◽  
Eric Klug ◽  
...  
Keyword(s):  
Mental Health ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Heart Failure Clinic ◽  
High Prevalence ◽  
Prevalence Of Depression ◽  
The Impact ◽  
Predictors Of Depression

Abstract Background: In high income countries depression is reported to affect at least one-fifth of patients with chronic heart failure (CHF). Mental health problems have been associated with frequent rehospitalisation and an increased risk of all-cause mortality. Despite the reported high prevalence of depression in CHF, there is a paucity of data on this subject from the developing world. The aim of the study was to determine the prevalence of depression, stress and anxiety in patients attending a dedicated chronic heart failure clinic. Methods: A prospective study was conducted at an outpatient heart failure clinic, in a tertiary academic centre over a nine month period in 2016. The study participants completed a Depression, Anxiety and Stress (DASS-21) questionnaire to screen for the presence and severity of depression, anxiety and stress. Descriptive statistics and logistic regression analysis was used to identify predictors of depression.Results: The study population comprised of 103 patients, predominantly female (62.1%) with a median age of 53 (interquartile range 38 – 61). Hypertension was the most common co-morbidity, reported in 35.9% of patients. Depression was reported by 54 (52.4%) with 12(11.7%) reporting extremely severe depression. Anxiety was diagnosed in 55 (53.4%) patients with extremely severe anxiety reported by 19 (18.4%) patients. Fifty patients (48.5%) were classified as stressed and only 8 (7.7%) had extremely severe stress. More than half of the patients (54.4%) were in New York Heart Association (NYHA) functional class I with a mean (SD) left ventricular ejection (LVEF) of 30.5 (11.1) %. The six-minute walk test (odds ratio (OR) -0.07, 95% confidence interval (CI) -0.01 – 0.00, p=0.012) and the Minnesota Living with Heart Failure score (OR 0.04, CI 0.02 – 0.01, p=0.001) were identified as independent predictors of depression. Conclusion: The prevalence of depression and anxiety was found in over half of our patients attending the chronic heart failure clinic. In view of the high prevalence of psychosocial stressors in CHF, we recommend that mental health screening should be considered. Prospective, adequately powered, multicentre studies from developing countries investigating the impact of depression on heart failure hospitalisation and mortality are still required.

scholarly journals Exploratory study on the psychological impact of COVID-19 on the general Brazilian population

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245868
Author(s):  
Antonio P. Serafim ◽  
Ricardo S. S. Durães ◽  
Cristiana C. A. Rocca ◽  
Priscila D. Gonçalves ◽  
Fabiana Saffi ◽  
...  
Keyword(s):  
Mental Health ◽  
Online Survey ◽  
Psychological Impact ◽  
High Stress ◽  
Federal District ◽  
Brazilian Population ◽  
Symptoms Of Depression ◽  
Stress Symptoms ◽  
Prevalence Of Depression ◽  
Stress Burden

The COVID-19 pandemic has become one of the main international concerns regarding its impact on mental health. The present study aims to investigate the prevalence of depression, anxiety, and stress symptoms, and behavioral aspects amidst the COVID-19 pandemic in a Brazilian population. An online survey was administered from May 22 to June 5, 2020 using a questionnaire comprising of sociodemographic information, the Depression, Anxiety, and Stress Scale (DASS-21), and the Coping Strategies Inventory. Participants comprised 3,000 people from Brazil’s 26 states and the Federal District, with an average age of 39.8 years, women (83%), married (50.6%), graduates (70.1%) and employees (46.7%). Some contracted the virus (6.4%) and had dead friends or relatives (22.7%). There was more consumption of drugs, tobacco, medication, and food (40.8%). Almost half of participants expressed symptoms of depression (46.4%), anxiety (39.7%), and stress (42.2%). These were higher in women, people without children, students, patients with chronic diseases, and people who had contact with others diagnosed with COVID-19. The existence of a group more vulnerable to situations with a high stress burden requires greater attention regarding mental health during and after the pandemic. That said, it should be emphasized that these findings are preliminary and portray a moment still being faced by many people amid the pandemic and quarantine measures. Therefore, we understand that the magnitude of the impacts on mental health will only be more specific with continuous studies after total relaxation of the quarantine.

scholarly journals COVID-19 and mental well-being of nurses in a tertiary facility in Kenya

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254074
Author(s):  
Sayed K. Ali ◽  
Jasmit Shah ◽  
Zohray Talib
Keyword(s):  
Mental Health ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Symptoms Of Depression ◽  
The Impact

Background The 2019 coronavirus disease (COVID-19) epidemic is a global health emergency which has been shown to pose a great challenge to mental health, well-being and resilience of healthcare workers, especially nurses. Little is known on the impact of COVID-19 among nurses in sub-Saharan Africa. Methods A cross sectional study was carried out between August and November 2020 among nurses recruited from the Aga Khan University Hospital, Nairobi. The survey questionnaire consisted of six components- demographic and work title characteristics, information regarding care of COVID-19 patients, symptoms of depression, anxiety, insomnia, distress and burnout, measured using standardized questionnaires. Multivariable logistic regression analysis was performed to identify factors associated with mental health disorders. Results Of 255 nurses, 171 (67.1%) consented to complete the survey. The median age of the participants was 33.47 years, 70.2% were females and 60.8% were married. More than half, 64.9% were frontline workers directly engaged in COVID-19 care. Only 1.8% reported a prior history or diagnosis of any mental health disorder. Depression, anxiety, insomnia, distress, and burnout were reported in 45.9%, 48.2%, 37.0%, 28.8% and 47.9% of all nurses. Frontline nurses reported experiencing more moderate to severe symptoms of depression, distress and burnout. Furthermore, females reported more burnout as compared to males. Multivariate logistic regression analysis showed that after adjustment, working in the frontlines was an independent risk variable for depression and burnout. Conclusion This is one of the few studies looking at mental health outcomes among nurses during the COVID-19 pandemic in Kenya. Similar to other studies from around the world, nurses directly involved with COVID-19 patients reported higher rates of mental health symptoms. Burnout threatens to exacerbate the pre-existing severe nursing workforce shortage in low-resource settings. Cost-effective and feasible mitigating strategies, geared to low-middle income countries, are urgently needed to help cope with mental health symptoms during such a pandemic.

Depression and anxiety symptoms in 17 teams of female football players including 10 German first league teams

2018 ◽  
Vol 53 (8) ◽  
pp. 471-477 ◽  
Author(s):  
Astrid Junge ◽  
Birgit Prinz
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Mental Health Problems ◽  
Anxiety Symptoms ◽  
Depression Symptoms ◽  
Football Players ◽  
Depression And Anxiety ◽  
Generalised Anxiety Disorder ◽  
Symptoms Of Depression ◽  
Prevalence Of Depression

BackgroundInformation on the prevalence of mental health problems of elite athletes is inconclusive, most probably due to methodological limitations, such as low response rates, heterogeneous samples.AimsTo evaluate the prevalence and risk factors of depression and anxiety symptoms in high-level female football players.MethodsFemale football players of 10 German first league (Bundesliga) and 7 lower league teams were asked to answer a questionnaire on players’ characteristics, the Center of Epidemiologic Studies Depression Scale (CES-D) and the Generalised Anxiety Disorder (GAD-7) scale.ResultsA total of 290 players (184 first and 106 lower league players) took part in the study. The CES-D score indicated mild to moderate symptoms of depression in 48 (16.6%) and severe symptoms in 41 (14.1%) players. The GAD-7 score indicated an at least moderate generalised anxiety disorder in 24 (8.3%) players. The prevalence of depression symptoms and generalised anxiety disorders was similar to the female general population of similar age. However, significantly more second league players reported symptoms of depression than first league players, and thus the prevalence of depression symptoms in second league players was higher than in the general population. Only a third of the 45 (15.7%) players who stated that they currently wanted or needed psychotherapeutic support received it.ConclusionThe prevalence of depression and generalised anxiety symptoms in elite football players is influenced by personal and sport-specific variables. It is important to raise awareness of athletes’ mental health problems in coaches and team physicians, to reduce stigma and to provide low-threshold treatment.

scholarly journals Effects of the lockdown on the mental health of the general population during the COVID-19 pandemic in Italy: Results from the COMET collaborative network

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Andrea Fiorillo ◽  
Gaia Sampogna ◽  
Vincenzo Giallonardo ◽  
Valeria Del Vecchio ◽  
Mario Luciano ◽  
...  
Keyword(s):  
Mental Health ◽  
General Population ◽  
Regression Models ◽  
Online Survey ◽  
Mental Health Problems ◽  
Well Being ◽  
Anxiety Symptoms ◽  
Italian Population ◽  
Stress Symptoms ◽  
The Impact

Abstract Background The Coronavirus disease 2019 (COVID-19) pandemic is an unprecedented traumatic event influencing the healthcare, economic, and social welfare systems worldwide. In order to slow the infection rates, lockdown has been implemented almost everywhere. Italy, one of the countries most severely affected, entered the “lockdown” on March 8, 2020. Methods The COvid Mental hEalth Trial (COMET) network includes 10 Italian university sites and the National Institute of Health. The whole study has three different phases. The first phase includes an online survey conducted between March and May 2020 in the Italian population. Recruitment took place through email invitation letters, social media, mailing lists of universities, national medical associations, and associations of stakeholders (e.g., associations of users/carers). In order to evaluate the impact of lockdown on depressive, anxiety and stress symptoms, multivariate linear regression models were performed, weighted for the propensity score. Results The final sample consisted of 20,720 participants. Among them, 12.4% of respondents (N = 2,555) reported severe or extremely severe levels of depressive symptoms, 17.6% (N = 3,627) of anxiety symptoms and 41.6% (N = 8,619) reported to feel at least moderately stressed by the situation at the DASS-21. According to the multivariate regression models, the depressive, anxiety and stress symptoms significantly worsened from the week April 9–15 to the week April 30 to May 4 (p < 0.0001). Moreover, female respondents and people with pre-existing mental health problems were at higher risk of developing severe depression and anxiety symptoms (p < 0.0001). Conclusions Although physical isolation and lockdown represent essential public health measures for containing the spread of the COVID-19 pandemic, they are a serious threat for mental health and well-being of the general population. As an integral part of COVID-19 response, mental health needs should be addressed.

scholarly journals Exploring the impact of a complex intervention for women with depression in contexts of adversity: A pilot feasibility study of COURRAGE-plus in South Africa

2021 ◽  
pp. 002076402110102
Author(s):  
Rochelle A Burgess ◽  
Niklas Jeske ◽  
Shahana Rasool ◽  
Ayesha Ahmad ◽  
Anna Kydd ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Narrative Therapy ◽  
Mental Distress ◽  
Social Intervention ◽  
Friedman Test ◽  
Time Points ◽  
Symptoms Of Depression ◽  
The Impact ◽  
Collective Narrative

Background: Depression is a leading cause of disease burden worldwide but is often undertreated in low- and middle-income countries. Reasons behind the treatment gap vary, but many highlight a lack of interventions which speak to the socio-economic and structural realties that are associated to mental health problems in many settings, including South Africa. The COURRAGE-PLUS intervention responds to this gap, by combining a collective narrative therapy (9 weeks) intervention, with a social intervention promoting group-led practical action against structural determinants of poor mental health (4 weeks), for a total of 13 sessions. The overall aim is to promote mental health, while empowering communities to acknowledge, and respond in locally meaningful ways to social adversity linked to development of mental distress. Aim: To pilot and evaluate the effectiveness of a complex intervention – COURRAGE-PLUS on symptoms of depression as assessed by the Patient Health Questionnaire (PHQ-9) among a sample of women facing contexts of adversity in Gauteng, South Africa. Methods: PHQ-9 scores were assessed at baseline, post collective narrative therapy (midline), and post social intervention (endline). Median scores and corresponding interquartile ranges were computed for all time points. Differences in scores between time points were tested with a non-parametric Friedman test. The impact across symptom severities was compared descriptively to identify potential differences in impact across categories of symptom severity within our sample. Results: Participants’ ( n = 47) median depression score at baseline was 11 (IQR = 7) and reduced to 4 at midline (IQR = 7) to 0 at endline (IQR = 2.5). The Friedman test showed a statistically significant difference between depression scores across time points, [Formula: see text](2) = 49.29, p < .001. Median depression scores were reduced to 0 or 1 Post-Intervention across all four severity groups. Conclusions: COURRAGE-PLUS was highly effective at reducing symptoms of depression across the spectrum of severities in this sample of women facing adversity, in Gauteng, South Africa. Findings supports the need for larger trials to investigate collective narrative storytelling and social interventions as community-based interventions for populations experiencing adversity and mental distress.

scholarly journals Prognostic algorithms for the progression of chronic heart failure depending on the clinical phenotype

2019 ◽  
Vol 18 (3) ◽  
pp. 41-47
Author(s):  
E. A. Polunina ◽  
L. P. Voronina ◽  
E. A. Popov ◽  
I. S. Belyakova ◽  
O. S. Polunina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Logistic Regression ◽  
Chronic Heart Failure ◽  
Clinical Phenotype ◽  
Left Ventricular ◽  
Regression Method ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Logistic Regression Method

Aim. To develop a mathematical equation (algorithm) to predict the development of chronic heart failure (CHF) for three years, depending on the clinical phenotype.Material and methods. Three hundred forty five patients with CHF with a different left ventricular ejection fraction (preserved, mean, low) were examined. The control group included somatically healthy individuals (n=60). In all patients, 48 parameters that most widely characterize the pathogenesis of CHF (gender-anamnestic, clinical, instrumental, biochemical) were analyzed. To isolate phenotypes, dispersive and cluster analysis was used: the hierarchical classification method and the k-means method. In the development of algorithms we used binary logistic regression method. We used ROC curve to assess the quality of the obtained algorithms.Results. We identified four phenotypes in patients with CHF: fibro-rigid, fibro-inflammatory, inflammatory-destructive, dilated-maladaptive. For the first three phenotypes, a mathematical logistic regression method was used to develop mathematical models for predicting the progression of CHF for three years, with the release of predictors for each phenotype. Belonging to the dilatedmaladaptive phenotype according to the results of the analysis is already an indicator of an unfavorable prognosis in patients with CHF.Conclusion. The developed algorithms based on the selected phenotypes have high diagnostic sensitivity and specificity and can be recommended for use in clinical practice.

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