Thrall Graham, Lip Gregory Y H, Carroll Douglas, Lane Deirdre
University Department of Medicine, City Hospital, Birmingham, UK.
Chest. 2007 Oct;132(4):1259-64. doi: 10.1378/chest.07-0036. Epub 2007 Jul 23.
To examine the prevalence and persistence of depression and anxiety in patients with atrial fibrillation (AF), and their effect on future quality of life (QoL) status.
The Beck Depression Inventory and State-Trait Anxiety Inventory were completed by 101 patients with AF (62 men; mean age +/- SD, 66.3 +/- 11.0 years), who were compared to 97 patients with hypertension (as "disease control" subjects) in sinus rhythm (64 men; mean age, 68.0 +/- 7.2 years) at baseline and at 6 months. QoL was ascertained at both time points using Dartmouth Care Cooperative Information Project charts.
At baseline among AF patients, symptoms of depression, state anxiety, and trait anxiety prevailed in 38%, 28%, and 38%, respectively; analogous data for hypertensive patients were 30%, 23%, and 22%. AF patients displayed higher levels of trait anxiety (p < 0.05), with no significant differences in baseline depression, state anxiety, and QoL between patients with AF and disease control subjects. Symptoms of depression and anxiety (state and trait) persisted at 6 months in 36.8% and 33.3%, respectively. Symptoms of depression (p < 0.001) and anxiety (p < 0.001) at baseline, female gender (p = 0.01), ethnicity (p = 0.01), and employment status (p = 0.03) were significantly correlated with QoL at 6 months in the patients with AF. Multiple regression analysis revealed that baseline depression score provided the best independent prediction of 6-month QoL (R(2) = 0.20), although gender and employment status also entered the model.
Approximately one third of AF patients have elevated levels of depression and anxiety, which persist at 6 months. Symptoms of depression were the strongest independent predictor of future QoL in these patients.
研究心房颤动（AF）患者抑郁和焦虑的患病率及持续性，以及它们对未来生活质量（QoL）状况的影响。
101例AF患者（62例男性；平均年龄±标准差，66.3±11.0岁）完成了贝克抑郁量表和状态-特质焦虑量表，在基线期和6个月时与97例窦性心律的高血压患者（作为“疾病对照”对象）（64例男性；平均年龄，68.0±7.2岁）进行比较。在两个时间点均使用达特茅斯医疗合作信息项目图表确定QoL。
在AF患者中，基线期抑郁症状、状态焦虑和特质焦虑的患病率分别为38%、28%和38%；高血压患者的类似数据分别为30%、23%和22%。AF患者的特质焦虑水平较高（p<0.05），AF患者与疾病对照对象在基线期抑郁、状态焦虑和QoL方面无显著差异。抑郁和焦虑（状态和特质）症状在6个月时分别持续存在于36.8%和33.3%的患者中。AF患者基线期的抑郁症状（p<0.001）和焦虑症状（p<0.001）、女性性别（p=0.01）、种族（p=0.01）和就业状况（p=0.03）与6个月时的QoL显著相关。多元回归分析显示，基线期抑郁评分对6个月QoL的独立预测效果最佳（R²=0.20），尽管性别和就业状况也纳入了模型。
约三分之一的AF患者存在抑郁和焦虑水平升高的情况，且在6个月时持续存在。抑郁症状是这些患者未来QoL最强的独立预测因素。
