A longitudinal study of changes in depressive symptoms and risk factors for congestive heart failure
Background Depression is prevalent among patients with congestive heart failure (CHF) and is associated with increased mortality and healthcare use. However, most research on this association has focused on high-income countries, leaving a gap in knowledge regarding the relationship between depres...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-05-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472425000419/type/journal_article |
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| author | Julia Gallucci Justin Ng Maria T. Secara Brett D. M. Jones Colin Hawco M. Omair Husain Nusrat Husain Imran B. Chaudhry Aristotle N. Voineskos M. Ishrat Husain |
| author_facet | Julia Gallucci Justin Ng Maria T. Secara Brett D. M. Jones Colin Hawco M. Omair Husain Nusrat Husain Imran B. Chaudhry Aristotle N. Voineskos M. Ishrat Husain |
| author_sort | Julia Gallucci |
| collection | DOAJ |
| description |
Background
Depression is prevalent among patients with congestive heart failure (CHF) and is associated with increased mortality and healthcare use. However, most research on this association has focused on high-income countries, leaving a gap in knowledge regarding the relationship between depression and CHF in low-to-middle-income countries.
Aims
To identify changes in depressive symptoms and potential risk factors for poor outcomes among CHF patients.
Methods
Longitudinal data from 783 patients with CHF from public hospitals in Karachi, Pakistan, were analysed. Depressive symptom severity was assessed using the Beck Depression Inventory. Baseline and 6-month follow-up Beck Depression Inventory scores were clustered using Gaussian mixture modelling to identify separate depressive symptom subgroups and extract trajectory labels. Further, a random forest algorithm was used to determine baseline demographic, clinical and behavioural predictors for each trajectory.
Results
Four separate patterns of depressive symptom changes were identified: ‘good prognosis’, ‘remitting course’, ‘clinical worsening’ and ‘persistent course’. Key factors related to these classifications included behavioural and functional factors such as quality of life and disability, as well as the clinical severity of CHF. Specifically, poorer quality of life and New York Heart Association (NYHA) class 3 symptoms were linked to persistent depressive symptoms, whereas patients with less disability and without NYHA class 3 symptoms were more likely to exhibit a good prognosis.
Conclusions
By examining the progression of depressive symptoms, clinicians can better understand the factors influencing symptom development in patients with CHF and identify those who may require closer monitoring and appropriate follow-up care.
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| format | Article |
| id | doaj-art-7eb43a82c1844bceb846389aa021b657 |
| institution | Kabale University |
| issn | 2056-4724 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj-art-7eb43a82c1844bceb846389aa021b6572025-08-20T03:53:07ZengCambridge University PressBJPsych Open2056-47242025-05-011110.1192/bjo.2025.41A longitudinal study of changes in depressive symptoms and risk factors for congestive heart failureJulia Gallucci0https://orcid.org/0000-0002-7857-3859Justin Ng1Maria T. Secara2Brett D. M. Jones3Colin Hawco4M. Omair Husain5https://orcid.org/0000-0002-8575-3364Nusrat Husain6Imran B. Chaudhry7Aristotle N. Voineskos8M. Ishrat Husain9https://orcid.org/0000-0001-5771-5750Institute of Medical Science, University of Toronto, Toronto, Canada Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, CanadaInstitute of Medical Science, University of Toronto, Toronto, Canada Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, CanadaInstitute of Medical Science, University of Toronto, Toronto, Canada Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, CanadaInstitute of Medical Science, University of Toronto, Toronto, Canada Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, CanadaInstitute of Medical Science, University of Toronto, Toronto, Canada Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, CanadaInstitute of Medical Science, University of Toronto, Toronto, Canada Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, CanadaSchool of Health Sciences, Division of Psychology and Mental Health, University of Manchester, Manchester, UK Mersey Care NHS Foundation Trust, Liverpool, UKSchool of Health Sciences, Division of Psychology and Mental Health, University of Manchester, Manchester, UK Department of Psychiatry, Ziauddin University, Karachi, PakistanInstitute of Medical Science, University of Toronto, Toronto, Canada Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, CanadaInstitute of Medical Science, University of Toronto, Toronto, Canada Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada Background Depression is prevalent among patients with congestive heart failure (CHF) and is associated with increased mortality and healthcare use. However, most research on this association has focused on high-income countries, leaving a gap in knowledge regarding the relationship between depression and CHF in low-to-middle-income countries. Aims To identify changes in depressive symptoms and potential risk factors for poor outcomes among CHF patients. Methods Longitudinal data from 783 patients with CHF from public hospitals in Karachi, Pakistan, were analysed. Depressive symptom severity was assessed using the Beck Depression Inventory. Baseline and 6-month follow-up Beck Depression Inventory scores were clustered using Gaussian mixture modelling to identify separate depressive symptom subgroups and extract trajectory labels. Further, a random forest algorithm was used to determine baseline demographic, clinical and behavioural predictors for each trajectory. Results Four separate patterns of depressive symptom changes were identified: ‘good prognosis’, ‘remitting course’, ‘clinical worsening’ and ‘persistent course’. Key factors related to these classifications included behavioural and functional factors such as quality of life and disability, as well as the clinical severity of CHF. Specifically, poorer quality of life and New York Heart Association (NYHA) class 3 symptoms were linked to persistent depressive symptoms, whereas patients with less disability and without NYHA class 3 symptoms were more likely to exhibit a good prognosis. Conclusions By examining the progression of depressive symptoms, clinicians can better understand the factors influencing symptom development in patients with CHF and identify those who may require closer monitoring and appropriate follow-up care. https://www.cambridge.org/core/product/identifier/S2056472425000419/type/journal_articleCongestive heart failuredepressive symptom changeslongitudinal studylow-to-middle-income countriesprotective factors and risk factors |
| spellingShingle | Julia Gallucci Justin Ng Maria T. Secara Brett D. M. Jones Colin Hawco M. Omair Husain Nusrat Husain Imran B. Chaudhry Aristotle N. Voineskos M. Ishrat Husain A longitudinal study of changes in depressive symptoms and risk factors for congestive heart failure BJPsych Open Congestive heart failure depressive symptom changes longitudinal study low-to-middle-income countries protective factors and risk factors |
| title | A longitudinal study of changes in depressive symptoms and risk factors for congestive heart failure |
| title_full | A longitudinal study of changes in depressive symptoms and risk factors for congestive heart failure |
| title_fullStr | A longitudinal study of changes in depressive symptoms and risk factors for congestive heart failure |
| title_full_unstemmed | A longitudinal study of changes in depressive symptoms and risk factors for congestive heart failure |
| title_short | A longitudinal study of changes in depressive symptoms and risk factors for congestive heart failure |
| title_sort | longitudinal study of changes in depressive symptoms and risk factors for congestive heart failure |
| topic | Congestive heart failure depressive symptom changes longitudinal study low-to-middle-income countries protective factors and risk factors |
| url | https://www.cambridge.org/core/product/identifier/S2056472425000419/type/journal_article |
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