Prevalence of Depression in Adult Saudi Patients with ... · PDF filePrevalence of Depression...
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Prevalence of Depression in Adult Saudi Patients with Heart Failure
King Abdulaziz Medical City
Dalia Ali SN, M B Bdeir MD, Tara conboy NS
g yCardiovascular diseases management program
Saudi Heart Association22nd Annual Symposium
Disclosures: None
Cardiovascular Disease ManagementCardiovascular Disease Management Program In KAMC
E t bli h d i 2000♥ Established in 2000.♥ 4 programs: Heart failure Heart failure Atherosclerosis Cardiac diabetes educationCardiac diabetes education Life style modification
Nurse led, cardiologist supervised, and target oriented program.
BackgroundBackground
Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, f li f ilt l lf th di t b d lfeelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration.
WHO2011
BackgroundBackground
♥ Depression can become chronic , lead to substantial impairments in an individual's ability to take care of his or her everyday responsibilitiestake care of his or her everyday responsibilities
♥ Most studies of depression in patients with heart p pfailure have been carried out in developed countries and evaluated hospitalized patients
J Am Coll Cardiol, 2004
Prevalence of Depression in Patients with HF
♥ Hospitalized patients: 13% to 77.5%
♥ Out-patient (small studies): 13% to 42%and have not adequately accounted for thehave not adequately accounted for the impact of age, race, or gender
J Am Coll Cardiol, 2004
ObjectivesObjectives
♥ To study the prevalence of depression in adult Saudi population with HFadu t Saud popu at o t
♥ To identify factors that may affect♥ To identify factors that may affect prevalence of depression.
M th dMethods
♥ A retrospective study of a prospectivelycollected data Included the first 148 heart failurepatients who completed the patient healthquestionnaire ( PHQ9)
Methods♥ Inclusion criteriaMethods
■ All patient have history of heart failure with documented ejection fraction of ≤ 40%documented ejection fraction of ≤ 40%
■ All patients had at least one visit to the heart fail re clinic from Ma 2010 to October 2010failure clinic from May 2010 to October 2010.
Methods
♥
Methods
♥ Exclusion criteria
■ Patients known to have clinical depression or treated for depression prior to enrollment in the programprogram
Methods■ The questionnaire was carried out by nurses through confidential diagnostic interviewconfidential diagnostic interview
■ Medical and demographic data were obtained from the l t i t i d telectronic computerized system
■ Depression assessment was carried out via a pvalidated Arabic translated version of the Patient Health Questionnaire (PHQ)
PHQPHQ
■ PHQ-9 is a nine item depression scale
■ Powerful tool for diagnosing depression, in addition to, selection and monitoring of anti-depression treatmenttreatment
.
Dietrich AJ, Oxman TE, Burns MR, et al; Application of a depression management office system in community practice: a demonstration. J Am Board Fam Pract. 2003 Mar-Apr;16(2):107-14
PHQ
■ Validity of PHQ has been assessed against i d d t t t d t l h lth
PHQ
an independent structured mental health professional interview. PHQ-9 score ≥10 had a sensitivity of 88% and a specificity of 88%a sensitivity of 88% and a specificity of 88% for major depression.
■ PHQ is easy to administer, accessible, free and is accepted culturally in our patientand is accepted culturally in our patient population
Kroenke K, Spitzer RL, Williams JB; The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13
B li Ch t i tiBaseline Characteristics
Characteristics Total (n=148)Characteristics Total (n=148)
Mean Age (years )Mean Age (years ) 61±11
Male Gender Male Gender 72%
DM 68%
HTN 68%
BMI>30 50%
Dyslipidemia 87%
ResultsResults
72% 107males
28%
41females
28%
Males FemalesMales Females
Total patients: 148 (72% males 28% females )Total patients: 148 (72% males, 28% females )
Depression With Age
50%
Depression With Age
36%35%40%45%
26%
20%25%30%35%
10%15%20%
0%5%
Age ≤60 Age>60g g
Prevalence Of Comorbidities In none Depressed Patients
100.0%
p
70.0%80.0%90.0%
40.0%50.0%60.0%
40% 37% 45%24%10.0%
20.0%30.0%
%
0.0%10.0%
DM HTN Dyslipidemia Obesity
Prevalence Of Comorbidities In Depressed Patients
100.0%
p
70.0%80.0%90.0%
85% 77%88%40.0%
50.0%60.0%
77% 69%
10.0%20.0%30.0%
%
0.0%10.0%
DM HTN Dyslipidemia Obesity
ResultsResults
■ 32 % of the total patients experiencep pdifferent degrees of depression
■ Depressed patients tended to be youngery g
■ Women were more likely (54%) to y ( )be depressed
Results■ Depression is more common in patients with other
multiple co morbidities like obesity hypertension
Results
multiple co morbidities like obesity , hypertension and DM.
OR
■ Existence of multiple comorbidities in patient with HF make them more likely to have some degree of depressionp
ConclusionConclusion
♥ Depression is prevalent in adult Saudi patients with HF
♥ It is considerably higher in certain groups such as females , young age and patients with other multiple co morbidities like obesity h t i d DM, hypertension and DM.