Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-23T04:34:04.825Z Has data issue: false hasContentIssue false

Depression risk in patients with heart failure in primary care practices in Germany

Published online by Cambridge University Press:  16 June 2016

Marcel Konrad
Affiliation:
Fresenius University of Applied Sciences, Idstein, Germany
Jens Bohlken
Affiliation:
Psychiatric Practice Bohlken, Berlin, Germany
Michael A Rapp
Affiliation:
Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
Karel Kostev*
Affiliation:
IMS Health, Frankfurt am Main, Germany
*
Correspondence should be addressed to: Prof. Dr Karel Kostev, IMS Health, Epidemiology, Darmstädter Landstraße 1089, 60598 Frankfurt am Main, Germany. Phone: +49 69 6604 4878. Email: [email protected].
Get access

Abstract

Background:

The goal of this study was to estimate the prevalence of and risk factors for diagnosed depression in heart failure (HF) patients in German primary care practices.

Methods:

This study was a retrospective database analysis in Germany utilizing the Disease Analyzer® Database (IMS Health, Germany). The study population included 132,994 patients between 40 and 90 years of age from 1,072 primary care practices. The observation period was between 2004 and 2013. Follow-up lasted up to five years and ended in April 2015. A total of 66,497 HF patients were selected after applying exclusion criteria. The same number of 66,497 controls were chosen and were matched (1:1) to HF patients on the basis of age, sex, health insurance, depression diagnosis in the past, and follow-up duration after index date.

Results:

HF was a strong risk factor for diagnosed depression (p < 0.0001). A total of 10.5% of HF patients and 6.3% of matched controls developed depression after one year of follow-up (p < 0.001). Depression was documented in 28.9% of the HF group and 18.2% of the control group after the five-year follow-up (p < 0.001). Cancer, dementia, osteoporosis, stroke, and osteoarthritis were associated with a higher risk of developing depression. Male gender and private health insurance were associated with lower risk of depression.

Conclusions:

The risk of diagnosed depression is significantly increased in patients with HF compared to patients without HF in primary care practices in Germany.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albrecht, K. (2014). Gender-spezifische Unterschiede der Komorbidität bei rheumatoider Arthritis. Zeitschrift für Rheumatologie, 73, 607614.Google Scholar
Becher, H., Kostev, K. and Schröder-Bernhardi, D. (2009). Validity and representativeness of the “Disease Analyzer” patient database for use in pharmacoepidemiological and pharmacoeconomic studies. International Journal of Clinical Pharmacology and Therapeutics, 47, 617626.Google Scholar
Bleumink, G. S. et al. (2004). Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure. The rotterdam study. European Heart Journal, 25, 16141619.Google Scholar
Busch, M., Maske, U., Ryl, L., Schlack, R. and Hapke, U. (2013). Prävalenz von depressiver Symptomatik und diagnostizierter Depression bei Erwachsenen in Deutschland. Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, 56, 733739.Google Scholar
Currier, M. B. and Nemeroff, C. B. (2014). Depression as a risk factor for cancer: from pathophysiological advances to treatment implications. Annual Review of Medicine, 65, 203221 Google Scholar
De Hert, M. et al. (2011). Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry, 10, 5277.Google Scholar
Debus, E. S. et al. (2013). Manifestation und prävention der arteriosklerose. Gefässchirurgie, 18, 644651.Google Scholar
Edelmann, F. (2015). Epidemiologie und prognose der herzinsuffizienz. Herz, 40, 176184 Google Scholar
Ewen, S. and Böhm, M. (2015). Too much is too much: evidence against dual RAAS inhibition in hypertensives with heart failure symptoms. European Heart Journal, 36, 899901.Google Scholar
Ewen, S., Mahfoud, F. and Böhm, M. (2015). Chronische Herzinsuffizienz Aktuelle Leitlinienempfehlun-gen und neue Erkenntnisse. Internist, 56, 791802.CrossRefGoogle Scholar
Gustad, L. T., Laugsand, L. E., Janszky, I., Dalen, H. and Bjerkeset, O. (2014). Symptoms of depression and risk of heart failure. The HUNT 2 study. European Journal of Cardiovascular Nursing, 16, 861–70.Google Scholar
Hellmann-Regen, J., Regen, F., Heuser, I., Endres, M. and Otte, C. (2014). Diagnostik und therapie der post-stroke-depression. DNP - Der Neurologe und Psychiater, 15, 6168 Google Scholar
Heßlinger, B. et al. (2002). Komorbidität von depressiven Störungen und kardiovaskulären Erkrankungen. Nervenarzt, 73, 205218.Google Scholar
Lederbogen, F., Schwarz, P., Häfner, S., Schweiger, U., Bohus, M. and Deuschle, M. (2015). Kardiale und metabolische Risikofaktoren bei schweren psychischen Erkrankungen. Nervenarzt, 86, 866871.Google Scholar
Lübeck, R., Beyer, M. and Gerlach, F. (2015). Rationale und stand der hausarztzentrierten Versorgung in Deutschland. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, 58, 360366.Google Scholar
Müller-Tasch, T. et al. (2007). Psychosomatik der herzinsuffizienz. Die Medizinische Welt, 58, 1316.Google Scholar
Nichols, M., Townsend, N., Scarborough, P. and Rayner, M. (2014). Cardiovascular disease in Europe 2014: epidemiological update. European Heart Journal, 35, 29502959.Google Scholar
Peeters, A., Mamun, A. A., Willekens, F. and Bonneux, L. (2002). A cardiovascular life history. A life course analysis of the original framingham heart study cohort. European Heart Journal, 23, 458466.Google Scholar
Petersson, S., Mathillas, J., Wallin, K., Olofsson, B., Allard, P. and Gustafson, Y. (2014). Risk factors for depressive disorders in very old age: a population-based cohort study with a 5-year follow-up. Social Psychiatry and Psychiatric Epidemiology, 49, 831839.Google Scholar
Pieper, L., Schulz, H., Klotsche, J., Eichler, T. and Wittchen, H. U. (2008). Depression als komorbide Störung in der primärärztlichen Versorgung. Bundesgesundheitsblatt - Gesundheitsforschung – Gesundheitsschutz, 51, 411421.Google Scholar
Polikandrioti, M. et al. (2015). Factors associated with depression and anxiety of hospitalized patients with heart failure. Hellenic Journal of Cardiology, 56, 2635.Google Scholar
Ramsay, S. E., Whincup, P. H., Papacosta, O., Morris, R. W., Lennon, L. T. and Wannamethee, S. G. (2014). Inequalities in heart failure in older men: prospective associations between socio- economic measures and heart failure incidence in a 10-year follow-up study. European Heart Journal, 35, 442447.Google Scholar
Rapp, M. A. et al. (2006). Increased hippocampal plaques and tangles in patients with Alzheimer disease with a lifetime history of major depression. Archives of General Psychiatry, 63, 161167.Google Scholar
Rapp, M. A. et al. (2011). Cognitive decline in patients with dementia as a function of depression. The American Journal of Geriatric Psychiatry, 19, 357363.Google Scholar
Snowden, M. B. et al. (2015). Association of dementia and depression. The American Journal of Geriatric Psychiatry, 23, 897905.Google Scholar
Uemura, K. (1988). International trends in cardiovascular diseases in the elderly. European Heart Journal, 9, 18.Google Scholar