Being Supportive Can Make a Difference

Depression in heart failure patients may be reduced with improved social support systems

January 27, 2013 / Author:  / Reviewed by: Robert Carlson, M.D

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(dailyRx News) When someone close to you is diagnosed with heart failure, they may become depressed and have trouble dealing with stress. But being supportive could lessen their depression and may even improve their health.

Depression is not good for patients with heart failure. It may lead to more hospitalizations and even death.

Having to deal with heart failure may be what causes the depression. Feeling isolated and lacking support may worsen depression.

A recent study suggested that improving the social support of heart failure patients may reduce their psychological distress. Reducing depression might hopefully improve patients' health outcomes.

"Tell your doctor if you have any depressive symptoms."

Erika Friedmann, PhD, of the School of Nursing at University of Maryland, and colleagues led the study to look at psychological stress and social support in heart failure patients.

The study included 108 patients. These patients were part of another study that examined a certain treatment for heart failure. The first group had an implantable cardioverter defibrillator inserted. The second group did not. The defibrillator is inserted in the heart. It can deliver a shock if the heart beats abnormally or stops. 

The patients were given several questionnaires that measured depression, anxiety and social support. The patients were followed for two years and filled out the same questionnaires every six months.

At the start of the study, 30 percent of the patients were depressed and 42 percent had anxiety. There were no differences between the groups that did or did not have an implantable cardioverter defibrillator. The two groups had the same levels of distress and social support.

The percentage of patients reporting anxiety remained the same for the two-year period. Depression increased among patients that reported a lack of social support.

The authors suggested improving a patient's support system could reduce their depression — and that reducing psychological distress and improving social support systems may improve health outcomes. 

"It is important to consider whether intervention to improve psychological status in this group of heart failure patients will have a positive impact on depression and, thus, on health outcomes," the authors commented.

The authors noted some limitations of the study. The measurement of depression and anxiety were from self-reported questionnaires. While the questionnaires are widely used, they do not provide a diagnosis. The study did not look at other factors in patients' lives, such as treatment for depression. Also, the study did not include differences between genders or races and the study results may not be generalizable.

This study - titled "Poor Social Support is Associated with Increases in Depression but not Anxiety Over 2 Years in Heart Failure Outpatients" - was published in the Journal of Cardiovascular Nursing. The study was funded by National Institute of Nursing Research, National Institutes of Health, National Heart, Lung and Blood Institute, Medtronic, Wyeth-Ayerst Laboratories and Knoll Pharmaceuticals. Dr. Friedmann and colleagues disclosed no conflicts of interest.