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心力衰竭门诊患者的抑郁和焦虑。

Depression and anxiety in ambulatory patients with heart failure.

机构信息

Houston Center for Quality of Care & Utilization Studies, Health Services Research and Development Service, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.

出版信息

Psychosomatics. 2009 Nov-Dec;50(6):592-8. doi: 10.1176/appi.psy.50.6.592.

Abstract

BACKGROUND

Depression and anxiety are common in heart failure, but the prevalence, incidence, and relationship of these conditions to health service use and mortality remains uncertain.

OBJECTIVE

The authors sought to delineate these parameters and identify patient factors predicting hospitalizations for heart failure and mortality 12 months after their initial diagnosis of heart failure.

METHOD

The authors utilized a retrospective database cohort of 12,028 ambulatory patients with newly diagnosed heart failure to examine diagnosed depression and anxiety and the relationship of these conditions to health service use and all-cause mortality.

RESULTS

Patients with diagnosed depression and/or anxiety (18% of the cohort) were frequently identified by providers within the first 30 days after a heart failure diagnosis. They subsequently utilized twice as many health services, but they did not show increased mortality risk.

DISCUSSION

Although mental health intervention data for heart failure patients are limited, the prevalence and impact of depression and anxiety in these patients suggest that assessment and intervention efforts appear warranted early in the heart failure process.

摘要

背景

抑郁症和焦虑症在心力衰竭患者中较为常见,但这些疾病的患病率、发病率以及与医疗服务利用和死亡率的关系尚不确定。

目的

作者旨在明确这些参数,并确定心力衰竭初始诊断后 12 个月内导致心力衰竭住院和死亡的患者因素。

方法

作者利用一个新诊断为心力衰竭的门诊患者的回顾性数据库队列,检查已确诊的抑郁和焦虑情况,以及这些情况与医疗服务利用和全因死亡率的关系。

结果

在心力衰竭诊断后的 30 天内,有 18%的患者被医疗服务提供者明确诊断为患有抑郁和/或焦虑。随后,他们使用了两倍多的医疗服务,但并未显示出更高的死亡风险。

讨论

尽管心力衰竭患者的心理健康干预数据有限,但这些患者中抑郁和焦虑的患病率和影响表明,在心力衰竭进程的早期,评估和干预工作似乎是合理的。

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