NISHIMURA Katsuji
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor and Division head
Article types Original article
Language English
Peer review Peer reviewed
Title Patient Health Questionnaire-2 Screening for Depressive Symptoms in Japanese Outpatients with Heart Failure.
Journal Formal name:Internal medicine
Abbreviation:Intern Med
ISSN code:0918-2918/1349-7235
Domestic / ForeginDomestic
Publisher The Japanese Society of Internal Medicine
Volume, Issue, Page 58(12),pp.1689-1694
Author and coauthor SUZUKI Tsuyoshi†, SHIGA Tsuyoshi*, NISHIMURA Katsuji, OMORI Hisako, TATSUMI Fujio, HAGIWARA Nobuhisa
Publication date 2019/06
Summary Objective: Depression is common in patients with heart failure (HF) and is a possible risk factor for adverse outcomes. The aim of this study was to determine the prevalence of depression assessed by the 2-item Patient Health Questionnaire (PHQ-2) and the effect of depression on outcomes in Japanese outpatients with HF.

Methods: This sub-analysis of a prospective observational study assessed 976 patients with HF (mean age 66±13 years; 26.7% female; 42.7% with an ischemic etiology). Depression was defined as a PHQ-2 score ≥3. The main composite outcome was death from any cause or hospitalization due to worsening HF. PHQ-2 items were extracted from the PHQ-9 results. To evaluate the association of PHQ-2 scores with outcomes, Cox proportional hazards models were evaluated.

Results: Fifty-seven (5.8%) patients were diagnosed with depression. During a median follow-up of 21 months, the incidence rates for death from any cause and hospitalization due to worsening HF in patients with and without depression were 2.2 vs. 0.9 per 100 person-years and 6.7 vs. 1.6, p<0.001, respectively. There was a higher incidence of the main outcome in patients with depression than in those without depression (p<0.001). After adjustment for conventional risk factors, depression (PHQ-2 ≥3) was an independent predictor of the main outcome (hazard ratio 2.41, 95% confidence interval 1.14-4.67, p=0.022), and a score for item 1 of the PHQ-2 (loss of interest or pleasure) ≥2 was also an independent risk factor (hazard ratio 3.57, 95% confidence interval 1.85-6.46, p<0.001).

Conclusion: Depression as assessed by the PHQ-2 was identified in 5.8% of Japanese outpatients with HF and was associated with outcomes.
DOI 10.2169/internalmedicine.2034-18
PMID 30799347