EXPLORING THE BIDIRECTIONAL RELATIONSHIP: HEART FAILURE AND ANXIETY/DEPRESSION

Abstract

Background: Heart failure (HF) is a complex syndrome associated with high morbidity, mortality, and impaired quality of life. Anxiety and depression are common comorbidities in HF, contributing to poorer prognosis, reduced treatment adherence and diminished quality of life. Screening for psycho-emotional disturbances and integration of multidisciplinary, patient-centered can significantly improve patient outcomes.  Objectives: The study explored correlations between HF, anxiety, and depression in order to optimize management strategies. Methods: This observational study was conducted over a three-month period across five family settings. A total of 103 patients diagnosed with HF were enrolled based on specific inclusion and exclusion criteria. Data collection involved three questionnaires assessing demographic, clinical, and psycho-emotional characteristics. The Hospital Anxiety and Depression Scale (HADS) was used to quantify anxiety and depression. Statistical analyses included correlation testing, group comparisons, and regression models.  Results. Among the participants, 32.04% exhibited clinical depression, and 26.21% had clinical anxiety. A statistically significant correlation was observed between HF severity and both anxiety (p=0.007) and depression (p=0.009) scores. Regarding healthcare visits, 60.19% of patients had between 4 and 8 family physician visits per year, while 25.24% had more than 8 visits. The qualitative aspects of anxiety included a heightened feeling that something bad is about to happen (14.56%), emotional tension that leads to psycho-emotional agitation (11.65%), restlessness and a constant desire for movement (15.53%). Frequently, these symptoms culminated in sudden panic attacks (10.68%). Patients who develop depression exhibit a maximum intensity of lack of energy (31.07%), followed by loss of interest in previously enjoyable activities and personal appearance (11.65%) and the inability to find joy in typically enjoyable situations. Conclusions. The symptoms of psycho-emotional disorders can often be identified during routine evaluations by family physician, who play a pivotal role in identifying these comorbidities early. Family physicians should incorporate validated tools like HADS into HF follow-up visits to screen for both clinical and subclinical symptoms. A multidisciplinary, collaborative approach is essential for improving both clinical outcomes and quality of life.