Mills Paul J, Wilson Kathleen, Iqbal Navaid, Iqbal Fatima, Alvarez Milagros, Pung Meredith A, Wachmann Katherine, Rutledge Thomas, Maglione Jeanne, Zisook Sid, Dimsdale Joel E, Lunde Ottar, Greenberg Barry H, Maisel Alan, Raisinghani Ajit, Natarajan Loki, Jain Shamini, Hufford David J, Redwine Laura
Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr. #0804, La Jolla, CA, 92093-0804, USA,
J Behav Med. 2015 Jun;38(3):407-15. doi: 10.1007/s10865-014-9615-0. Epub 2014 Dec 23.
Depression adversely predicts prognosis in individuals with symptomatic heart failure. In some clinical populations, spiritual wellness is considered to be a protective factor against depressive symptoms. This study examined associations among depressive symptoms, spiritual wellbeing, sleep, fatigue, functional capacity, and inflammatory biomarkers in 132 men and women with asymptomatic stage B heart failure (age 66.5 years ± 10.5). Approximately 32 % of the patients scored ≥10 on the Beck Depression Inventory, indicating potentially clinically relevant depressive symptoms. Multiple regression analysis predicting fewer depressive symptoms included the following significant variables: a lower inflammatory score comprised of disease-relevant biomarkers (p < 0.02), less fatigue (p < 0.001), better sleep (p < 0.04), and more spiritual wellbeing (p < 0.01) (overall model F = 26.6, p < 0.001, adjusted R square = 0.629). Further analyses indicated that the meaning (p < 0.01) and peace (p < 0.01) subscales, but not the faith (p = 0.332) subscale, of spiritual wellbeing were independently associated with fewer depressive symptoms. Interventions aimed at increasing spiritual wellbeing in patients lives, and specifically meaning and peace, may be a potential treatment target for depressive symptoms asymptomatic heart failure.
抑郁症对有症状的心力衰竭患者的预后有不利影响。在一些临床人群中,精神健康被认为是预防抑郁症状的一个保护因素。本研究调查了132名无症状B期心力衰竭男性和女性(年龄66.5岁±10.5岁)的抑郁症状、精神健康、睡眠、疲劳、功能能力和炎症生物标志物之间的关联。约32%的患者在贝克抑郁量表上得分≥10分,表明可能存在具有临床意义的抑郁症状。预测抑郁症状较少的多元回归分析纳入了以下显著变量:由疾病相关生物标志物组成的较低炎症评分(p<0.02)、较少的疲劳(p<0.001)、较好的睡眠(p<0.04)和更多的精神健康(p<0.01)(总体模型F=26.6,p<0.001,调整后R平方=0.629)。进一步分析表明,精神健康的意义(p<0.01)和平静(p<0.01)子量表,而非信仰(p=0.332)子量表,与较少的抑郁症状独立相关。旨在提高患者生活中的精神健康,特别是意义和平静的干预措施,可能是无症状心力衰竭患者抑郁症状的一个潜在治疗靶点。