Delville Carol L, McDougall Graham
School of Nursing, The University of Texas at Austin, Austin, Texas 78701, USA.
Issues Ment Health Nurs. 2008 Sep;29(9):1002-17. doi: 10.1080/01612840802274867.
Heart failure (HF) is a life-threatening condition affecting 2.5% of Americans. Depression is reported to be present in 9.5% of the general population, but its incidence is higher in individuals with HF. The aims of this systematic review of older adults with HF were to examine the literature to: (1) identify instruments used to evaluate depression/depressive symptoms; and (2) determine the incidence of depression/depressive symptoms reported. Sixteen articles met inclusion criteria. Six self-reporting screening instruments and two diagnostic-interviews for depression were identified. Depression/depressive symptoms were reported in 14-60% of adults with HF. Use of screening instruments resulted in higher frequencies of depression/depressive symptoms (21-60%) than did diagnostic interviews (14-39%). Screening instruments established prior to the 1987 diagnostic guidelines may not reflect the current definition of depression. Depression screening instruments appear to overestimate the incidence of depression in older adults with heart failure. A complete diagnostic interview for depression should be performed prior to the treatment of older adults with HF.
心力衰竭（HF）是一种危及生命的疾病，影响着2.5%的美国人。据报道，抑郁症在普通人群中的发病率为9.5%，但在心力衰竭患者中发病率更高。本项针对老年心力衰竭患者的系统评价旨在检索文献，以：（1）确定用于评估抑郁症/抑郁症状的工具；（2）确定所报道的抑郁症/抑郁症状的发病率。16篇文章符合纳入标准。确定了6种自我报告筛查工具和2种抑郁症诊断访谈方法。据报道，14%-60%的成年心力衰竭患者存在抑郁症/抑郁症状。使用筛查工具得出的抑郁症/抑郁症状发生率（21%-60%）高于诊断访谈得出的发生率（14%-39%）。1987年诊断指南之前建立的筛查工具可能无法反映当前抑郁症的定义。抑郁症筛查工具似乎高估了老年心力衰竭患者抑郁症的发病率。在治疗老年心力衰竭患者之前，应进行全面的抑郁症诊断访谈。
