Depression in Heart Failure: A Systematic Review

Waguih William Ishak; Gabriel Edwards; Nathalie Herrera; Tiffany Lin; Kathryn Hren; Michael Peterson; Ashley Ngor; Angela Liu; Asher Kimchi; Brennan Spiegel; Rebecca Hedrick; Robert Chernoff; Marcio Diniz; James Mirocha; Vicki Manoukian; Michael Ong; John Harold; Itai Danovitch; Michele Hamilton

Depression in Heart Failure: A Systematic Review

Innov Clin Neurosci. 2020 Apr 1;17(4-6):27-38.

Authors

Waguih William Ishak^{1

2

3}, Gabriel Edwards^{1

2

3}, Nathalie Herrera^{1

2

3}, Tiffany Lin^{1

2

3}, Kathryn Hren^{1

2

3}, Michael Peterson^{1

2

3}, Ashley Ngor^{1

2

3}, Angela Liu^{1

2

3}, Asher Kimchi^{1

2

3}, Brennan Spiegel^{1

2

3}, Rebecca Hedrick^{1

2

3}, Robert Chernoff^{1

2

3}, Marcio Diniz^{1

2

3}, James Mirocha^{1

2

3}, Vicki Manoukian^{1

2

3}, Michael Ong^{1

2

3}, John Harold^{1

2

3}, Itai Danovitch^{1

2

3}, Michele Hamilton^{1

2

3}

Affiliations

¹ Drs. IsHak, Edwards, Herrera, Lin, Spiegel, Hedrick, Chernoff, Diniz, Danovitch; Mr. Mirocha and Mr. Peterson; and Ms. Hren, Ms. Nigor, Ms. Liu, and Ms. Manoukian and are with the Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center in Los Angeles, California.
² Drs. Ishak, Spiegel, and Ong are with the David Geffen School of Medicine at UCLA in Los Angeles, California.
³ Drs. Kimchi, Harold, and Hamilton are with the Smidt Heart Institute, Cedars-Sinai Medical Center in Los Angeles, California.

PMID: 32802590
PMCID: PMC7413333

Abstract

Objective: This paper sought to identify the instruments used to measure depression in heart failure (HF) and elucidate the impact of treatment interventions on depression in HF. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. Studies published from 1988 to 2018 covering depression and HF were identified through the review of the PubMed and PsycINFO databases using the keywords: "depres*" AND "heart failure." Two authors independently conducted a focused analysis, identifying 27 studies that met the specific selection criteria and passed the study quality checks. Results: Patient-reported questionnaires were more commonly adopted than clinician-rated questionnaires, including the Beck Depression Inventory, the Patient Health Questionnaire (PHQ-9), and the Hospital Anxiety and Depression Scale. Six common interventions were observed: antidepressant medications, collaborative care, psychotherapy, exercise, education, and other nonpharmacological interventions. Except for paroxetine, selective serotonin reuptake inhibitors failed to show a significant difference from placebo. However, the collaborative care model including the use of antidepressants showed a significant decrease in PHQ-9 score after one year. All of the psychotherapy studies included a variation of cognitive behavioral therapy and patients showed significant improvements. The evidence was mixed for exercise, education, and other nonpharmacological interventions. Conclusion: This study suggests which types of interventions are more effective in addressing depression in heart failure patients.

Keywords: Adult attention-deficit/hyperactivity disorder; comorbid disorders; externalizing disorder; internalizing disorder; nosology.

Publication types

Review