Skip to main content

Advertisement

SpringerLink
Log in

Depression, Anxiety, and Cognitive Impairment

Comorbid Mental Health Disorders in Heart Failure

  • Comorbidities of Heart Failure (C Angermann, Section Editor)
  • Published:
Current Heart Failure Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Depression, anxiety, and cognitive impairment constitute established risk markers for incident cardiovascular disease (CVD) and are associated with impaired life expectancy and quality of life and high hospitalization rates and healthcare expenditure. This review summarizes current knowledge about mental health disorders in patients with CVD and heart failure (HF).

Recent Findings

Emerging evidence suggests various shared pathophysiological mechanisms between psychological comorbidities and CVD (e.g., systemic inflammation and autonomic dysfunction). Bi-directional interactions involving the central nervous and cardiovascular systems may help explain the rising prevalence of comorbid mood disorders with increasing CVD severity and support the concept of alternative pathophysiological mechanisms in the presence of severe somatic illness, making symptoms less responsive or unresponsive to psychotropic pharmacotherapy.

Summary

Considering high prevalence and negative impact of psychological comorbidities in CVD and HF, routine care should integrate screening for these conditions. Multidisciplinary treatment approaches with active patient participation in disease management were shown to improve outcomes. However, better understanding of factors mediating the adverse prognostic effects of mood disorders is needed. This might enable more targeted treatment and possibly also facilitate better understanding of the pathophysiological mechanisms driving CVD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Easton K, Coventry P, Lovell K, Carter LA, Deaton C. Prevalence and measurement of anxiety in samples of patients with heart failure: meta-analysis. J Cardiovasc Nurs. 2016;31:367–79.

    PubMed  PubMed Central  Google Scholar 

  2. Konstam V, Moser DK, De Jong MJ. Depression and anxiety in heart failure. J Card Fail. 2005;11:455–63.

    PubMed  Google Scholar 

  3. Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol. 2006;48:1527–37.

    PubMed  Google Scholar 

  4. Vaccarino V, Kasl SV, Abramson J, Krumholz HM. Depressive symptoms and risk of functional decline and death in patients with heart failure. J Am Coll Cardiol. 2001;38:199–205.

    CAS  PubMed  Google Scholar 

  5. • Cannon JA, Moffitt P, Perez-Moreno AC, Walters MR, Broomfield NM, McMurray JJV, et al. Cognitive impairment and heart failure: systematic review and meta-analysis. J Card Fail. 2017;23:464–75 This article provides a recent update on prevalence, incidence, and relative risk of cognitive impairment in heart failure.

    PubMed  Google Scholar 

  6. Alhurani AS, Dekker RL, Abed MA, Khalil A, Al Zaghal MH, Lee KS, et al. The association of co-morbid symptoms of depression and anxiety with all-cause mortality and cardiac rehospitalization in patients with heart failure. Psychosomatics. 2015;56:371–80.

    PubMed  Google Scholar 

  7. Angermann CE, Stork S, Gelbrich G, Faller H, Jahns R, Frantz S, et al. Mode of action and effects of standardized collaborative disease management on mortality and morbidity in patients with systolic heart failure: the Interdisciplinary Network for Heart Failure (INH) study. Circ Heart Fail. 2012;5:25–35.

    PubMed  Google Scholar 

  8. Celano CM, Villegas AC, Albanese AM, Gaggin HK, Huffman JC. Depression and anxiety in heart failure: a review. Harv Rev Psychiatry. 2018;26:175–84.

    PubMed  PubMed Central  Google Scholar 

  9. Freedland KE, Hesseler MJ, Carney RM, Steinmeyer BC, Skala JA, Davila-Roman VG, et al. Major depression and long-term survival of patients with heart failure. Psychosom Med. 2016;78:896–903.

    PubMed  PubMed Central  Google Scholar 

  10. Moraska AR, Chamberlain AM, Shah ND, Vickers KS, Rummans TA, Dunlay SM, et al. Depression, healthcare utilization, and death in heart failure: a community study. Circ Heart Fail. 2013;6:387–94.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Sayers SL, Hanrahan N, Kutney A, Clarke SP, Reis BF, Riegel B. Psychiatric comorbidity and greater hospitalization risk, longer length of stay, and higher hospitalization costs in older adults with heart failure. J Am Geriatr Soc. 2007;55:1585–91.

    PubMed  Google Scholar 

  12. Angermann CE, Gelbrich G, Stork S, Schowalter M, Deckert J, Ertl G, et al. Somatic correlates of comorbid major depression in patients with systolic heart failure. Int J Cardiol. 2011;147:66–73.

    PubMed  Google Scholar 

  13. Faller H, Stork S, Schowalter M, Steinbuchel T, Wollner V, Ertl G, et al. Depression and survival in chronic heart failure: does gender play a role? Eur J Heart Fail. 2007;9:1018–23.

    PubMed  Google Scholar 

  14. Faris R, Purcell H, Henein MY, Coats AJ. Clinical depression is common and significantly associated with reduced survival in patients with non-ischaemic heart failure. Eur J Heart Fail. 2002;4:541–51.

    CAS  PubMed  Google Scholar 

  15. Jacob S, Sebastian JC, Abraham G. Depression and congestive heart failure: are antidepressants underutilized? Eur J Heart Fail. 2003;5:399–400.

    PubMed  Google Scholar 

  16. Jiang W, Krishnan R, Kuchibhatla M, Cuffe MS, Martsberger C, Arias RM, et al. Characteristics of depression remission and its relation with cardiovascular outcome among patients with chronic heart failure (from the SADHART-CHF Study). Am J Cardiol. 2011;107:545–51.

    PubMed  PubMed Central  Google Scholar 

  17. Jiang W, Kuchibhatla M, Clary GL, Cuffe MS, Christopher EJ, Alexander JD, et al. Relationship between depressive symptoms and long-term mortality in patients with heart failure. Am Heart J. 2007;154:102–8.

    PubMed  Google Scholar 

  18. Sherwood A, Blumenthal JA, Trivedi R, Johnson KS, O’Connor CM, Adams KF Jr, et al. Relationship of depression to death or hospitalization in patients with heart failure. Arch Intern Med. 2007;167:367–73.

    PubMed  Google Scholar 

  19. Cully JA, Jimenez DE, Ledoux TA, Deswal A. Recognition and treatment of depression and anxiety symptoms in heart failure. Prim Care Companion J Clin Psychiatry. 2009;11:103–9.

    PubMed  PubMed Central  Google Scholar 

  20. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18:891–975.

    PubMed  Google Scholar 

  21. Piepenburg SM, Faller H, Stork S, Ertl G, Angermann CE. Symptom patterns and clinical outcomes in women versus men with systolic heart failure and depression. Clin Res Cardiol 2018. https://doi.org/10.1007/s00392-018-1348-6

  22. Lowe B, Grafe K, Zipfel S, Witte S, Loerch B, Herzog W. Diagnosing ICD-10 depressive episodes: superior criterion validity of the Patient Health Questionnaire. Psychother Psychosom. 2004;73:386–90.

    PubMed  Google Scholar 

  23. Wallenborn J, Angermann CE. Comorbid depression in heart failure. Herz. 2013;38:587–96.

    CAS  PubMed  Google Scholar 

  24. Dekker RL, Lennie TA, Doering LV, Chung ML, Wu JR, Moser DK. Coexisting anxiety and depressive symptoms in patients with heart failure. Eur J Cardiovasc Nurs. 2014;13:168–76.

    PubMed  PubMed Central  Google Scholar 

  25. Janszky I, Ahnve S, Lundberg I, Hemmingsson T. Early-onset depression, anxiety, and risk of subsequent coronary heart disease: 37-year follow-up of 49,321 young Swedish men. J Am Coll Cardiol. 2010;56:31–7.

    PubMed  Google Scholar 

  26. Roest AM, de Jonge P, Lim CWW, Stein DJ, Al-Hamzawi A, Alonso J, et al. Fear and distress disorders as predictors of heart disease: a temporal perspective. J Psychosom Res. 2017;96:67–75.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Suzuki T, Shiga T, Kuwahara K, Kobayashi S, Suzuki S, Nishimura K, et al. Impact of clustered depression and anxiety on mortality and rehospitalization in patients with heart failure. J Cardiol. 2014;64:456–62.

    PubMed  Google Scholar 

  28. Chapa DW, Akintade B, Son H, Woltz P, Hunt D, Friedmann E, et al. Pathophysiological relationships between heart failure and depression and anxiety. Crit Care Nurse. 2014;34:14–24 quiz 5.

    PubMed  Google Scholar 

  29. Angermann CE, Kaspar M, Marx A, Kittel-Schneider S, Menhofer D, Stork S, et al. A functional variant of the neuropeptide S receptor-1 gene modulates clinical outcomes and healthcare utilization in patients with systolic heart failure: results from the Interdisciplinary Network Heart Failure (INH) Study. Eur J Heart Fail. 2017;19:314–23.

    CAS  PubMed  Google Scholar 

  30. Phillips AC, Batty GD, Gale CR, Deary IJ, Osborn D, MacIntyre K, et al. Generalized anxiety disorder, major depressive disorder, and their comorbidity as predictors of all-cause and cardiovascular mortality: the Vietnam experience study. Psychosom Med. 2009;71:395–403.

    CAS  PubMed  Google Scholar 

  31. Rutledge T, Linke SE, Krantz DS, Johnson BD, Bittner V, Eastwood JA, et al. Comorbid depression and anxiety symptoms as predictors of cardiovascular events: results from the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation (WISE) study. Psychosom Med. 2009;71:958–64.

    PubMed  PubMed Central  Google Scholar 

  32. Alosco ML, Spitznagel MB, Raz N, Cohen R, Sweet LH, Colbert LH, et al. Obesity interacts with cerebral hypoperfusion to exacerbate cognitive impairment in older adults with heart failure. Cerebrovasc Dis Extra. 2012;2:88–98.

    PubMed  PubMed Central  Google Scholar 

  33. Gure TR, Blaum CS, Giordani B, Koelling TM, Galecki A, Pressler SJ, et al. Prevalence of cognitive impairment in older adults with heart failure. J Am Geriatr Soc. 2012;60:1724–9.

    PubMed  PubMed Central  Google Scholar 

  34. Almeida OP, Garrido GJ, Beer C, Lautenschlager NT, Arnolda L, Flicker L. Cognitive and brain changes associated with ischaemic heart disease and heart failure. Eur Heart J. 2012;33:1769–76.

    PubMed  Google Scholar 

  35. •• Ampadu J, Morley JE. Heart failure and cognitive dysfunction. Int J Cardiol. 2015;178:12–23 This article provides detailed insights into the pathophysiological mechanisms of cognitive impairment.

    PubMed  Google Scholar 

  36. Frey A, Sell R, Homola GA, Malsch C, Kraft P, Gunreben I, et al. Cognitive deficits and related brain lesions in patients with chronic heart failure. JACC Heart Fail. 2018;6:583–92.

    PubMed  Google Scholar 

  37. McCaffery JM, Frasure-Smith N, Dube MP, Theroux P, Rouleau GA, Duan Q, et al. Common genetic vulnerability to depressive symptoms and coronary artery disease: a review and development of candidate genes related to inflammation and serotonin. Psychosom Med. 2006;68:187–200.

    CAS  PubMed  Google Scholar 

  38. Domschke K, Reif A, Weber H, Richter J, Hohoff C, Ohrmann P, et al. Neuropeptide S receptor gene -- converging evidence for a role in panic disorder. Mol Psychiatry. 2011;16:938–48.

    CAS  PubMed  Google Scholar 

  39. Rozanski A, Blumenthal JA, Davidson KW, Saab PG, Kubzansky L. The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging field of behavioral cardiology. J Am Coll Cardiol. 2005;45:637–51.

    PubMed  Google Scholar 

  40. Grippo AJ, Johnson AK. Biological mechanisms in the relationship between depression and heart disease. Neurosci Biobehav Rev. 2002;26:941–62.

    PubMed  Google Scholar 

  41. Kop WJ, Gottdiener JS. The role of immune system parameters in the relationship between depression and coronary artery disease. Psychosom Med. 2005;67(Suppl 1):S37–41.

    PubMed  Google Scholar 

  42. Mahmoudi M, Curzen N, Gallagher PJ. Atherogenesis: the role of inflammation and infection. Histopathology. 2007;50:535–46.

    CAS  PubMed  Google Scholar 

  43. Engelhardt S, Patkar S, Ogunshola OO. Cell-specific blood-brain barrier regulation in health and disease: a focus on hypoxia. Br J Pharmacol. 2014;171:1210–30.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. Fan H, Yu W, Zhang Q, Cao H, Li J, Wang J, et al. Depression after heart failure and risk of cardiovascular and all-cause mortality: a meta-analysis. Prev Med. 2014;63:36–42.

    PubMed  Google Scholar 

  45. Bane C, Hughes CM, McElnay JC. The impact of depressive symptoms and psychosocial factors on medication adherence in cardiovascular disease. Patient Educ Couns. 2006;60:187–93.

    PubMed  Google Scholar 

  46. Hare DL, Toukhsati SR, Johansson P, Jaarsma T. Depression and cardiovascular disease: a clinical review. Eur Heart J. 2014;35:1365–72.

    PubMed  Google Scholar 

  47. World Health Organization. ICD-10 Classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992.

    Google Scholar 

  48. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Arlington VA: American Psychiatric Publishing; 2013.

    Google Scholar 

  49. Spitzer RL, Williams JB, Gibbon M, First MB. The Structured Clinical Interview for DSM-III-R (SCID). I: history, rationale, and description. Arch Gen Psychiatry. 1992;49:624–9.

    CAS  PubMed  Google Scholar 

  50. Lowe B, Kroenke K, Grafe K. Detecting and monitoring depression with a two-item questionnaire (PHQ-2). J Psychosom Res. 2005;58:163–71.

    PubMed  Google Scholar 

  51. Piepenburg SM, Faller H, Gelbrich G, Stork S, Warrings B, Ertl G, et al. Comparative potential of the 2-item versus the 9-item patient health questionnaire to predict death or rehospitalization in heart failure. Circ Heart Fail. 2015;8:464–72.

    PubMed  Google Scholar 

  52. Lichtman JH, Bigger JT Jr, Blumenthal JA, Frasure-Smith N, Kaufmann PG, Lesperance F, et al. Depression and coronary heart disease: recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association. Circulation. 2008;118:1768–75.

    PubMed  Google Scholar 

  53. Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092–7.

    PubMed  Google Scholar 

  54. Kroenke K, Spitzer RL, Williams JB, Monahan PO, Lowe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146:317–25.

    PubMed  Google Scholar 

  55. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.

    CAS  PubMed  Google Scholar 

  56. Dodson JA, Chaudhry SI. Geriatric conditions in heart failure. Curr Cardiovasc Risk Rep. 2012;6:404–10.

    PubMed  PubMed Central  Google Scholar 

  57. Harkness K, Demers C, Heckman GA, McKelvie RS. Screening for cognitive deficits using the Montreal cognitive assessment tool in outpatients >/=65 years of age with heart failure. Am J Cardiol. 2011;107:1203–7.

    PubMed  Google Scholar 

  58. •• Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry. 2015;72:334–41 This meta-analysis investigated the risk of mortality in patients with mental disorders worldwide.

    PubMed  PubMed Central  Google Scholar 

  59. Lesperance F, Frasure-Smith N, Talajic M, Bourassa MG. Five-year risk of cardiac mortality in relation to initial severity and one-year changes in depression symptoms after myocardial infarction. Circulation. 2002;105:1049–53.

    PubMed  Google Scholar 

  60. Rugulies R. Depression as a predictor for coronary heart disease. A review and meta-analysis. Am J Prev Med. 2002;23:51–61.

    PubMed  Google Scholar 

  61. Jiang W, Alexander J, Christopher E, Kuchibhatla M, Gaulden LH, Cuffe MS, et al. Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Arch Intern Med. 2001;161:1849–56.

    CAS  PubMed  Google Scholar 

  62. Freedland KE, Carney RM, Rich MW. Effect of depression on prognosis in heart failure. Heart Fail Clin. 2011;7:11–21.

    PubMed  PubMed Central  Google Scholar 

  63. Sokoreli I, de Vries JJ, Pauws SC, Steyerberg EW. Depression and anxiety as predictors of mortality among heart failure patients: systematic review and meta-analysis. Heart Fail Rev. 2016;21:49–63.

    CAS  PubMed  Google Scholar 

  64. Denollet J, Maas K, Knottnerus A, Keyzer JJ, Pop VJ. Anxiety predicted premature all-cause and cardiovascular death in a 10-year follow-up of middle-aged women. J Clin Epidemiol. 2009;62:452–6.

    PubMed  Google Scholar 

  65. Roest AM, Martens EJ, Denollet J, de Jonge P. Prognostic association of anxiety post myocardial infarction with mortality and new cardiac events: a meta-analysis. Psychosom Med. 2010;72:563–9.

    PubMed  Google Scholar 

  66. De Jong MJ, Chung ML, Wu JR, Riegel B, Rayens MK, Moser DK. Linkages between anxiety and outcomes in heart failure. Heart Lung. 2011;40:393–404.

    PubMed  PubMed Central  Google Scholar 

  67. • Pina IL, Di Palo KE, Ventura HO. Psychopharmacology and Cardiovascular Disease. J Am Coll Cardiol. 2018;71:2346–59 This state-of-the-art review discusses the association between common mental disorders and cardiovascular disease, including a review of psychotropic drug therapy and drug-drug interactions.

    CAS  PubMed  Google Scholar 

  68. Cohen HW, Gibson G, Alderman MH. Excess risk of myocardial infarction in patients treated with antidepressant medications: association with use of tricyclic agents. Am J Med. 2000;108:2–8.

    CAS  PubMed  Google Scholar 

  69. Frey A, Saxon VM, Popp S, Lehmann M, Mathes D, Pachel C, et al. Early citalopram treatment increases mortality due to left ventricular rupture in mice after myocardial infarction. J Mol Cell Cardiol. 2016;98:28–36.

    CAS  PubMed  Google Scholar 

  70. Woltz PC, Chapa DW, Friedmann E, Son H, Akintade B, Thomas SA. Effects of interventions on depression in heart failure: a systematic review. Heart Lung. 2012;41:469–83.

    PubMed  Google Scholar 

  71. Veien KT, Videbaek L, Schou M, Gustafsson F, Hald-Steffensen F, Hildebrandt PR. High mortality among heart failure patients treated with antidepressants. Int J Cardiol. 2011;146:64–7.

    PubMed  Google Scholar 

  72. O’Connor CM, Jiang W, Kuchibhatla M, Mehta RH, Clary GL, Cuffe MS, et al. Antidepressant use, depression, and survival in patients with heart failure. Arch Intern Med. 2008;168:2232–7.

    PubMed  Google Scholar 

  73. Piepenburg SM, Ertl G, Angermann CE. Depression and heart failure - a dangerous combination. Dtsch Med Wochenschr. 2016;141:1222–7.

    PubMed  Google Scholar 

  74. Glassman AH, O’Connor CM, Califf RM, Swedberg K, Schwartz P, Bigger JT Jr, et al. Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA. 2002;288:701–9.

    CAS  PubMed  Google Scholar 

  75. Berkman LF, Blumenthal J, Burg M, Carney RM, Catellier D, Cowan MJ, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial. JAMA. 2003;289:3106–16.

    PubMed  Google Scholar 

  76. Lesperance F, Frasure-Smith N, Koszycki D, Laliberte MA, van Zyl LT, Baker B, et al. Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: the Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial. JAMA. 2007;297:367–79.

    CAS  PubMed  Google Scholar 

  77. van den Brink RH, van Melle JP, Honig A, Schene AH, Crijns HJ, Lambert FP, et al. Treatment of depression after myocardial infarction and the effects on cardiac prognosis and quality of life: rationale and outline of the Myocardial INfarction and Depression-Intervention Trial (MIND-IT). Am Heart J. 2002;144:219–25.

    PubMed  Google Scholar 

  78. Kim JM, Bae KY, Stewart R, Jung BO, Kang HJ, Kim SW, et al. Escitalopram treatment for depressive disorder following acute coronary syndrome: a 24-week double-blind, placebo-controlled trial. J Clin Psychiatry. 2015;76:62–8.

    PubMed  Google Scholar 

  79. •• Kim JM, Stewart R, Lee YS, Lee HJ, Kim MC, Kim JW, et al. Effect of escitalopram vs placebo treatment for depression on long-term cardiac outcomes in patients with acute coronary syndrome: a randomized clinical trial. JAMA. 2018;320:350–8 This study is the first randomized controlled clinical trial to show positive long-term effects with SSRI therapy in patients with cardiovascular disease and comorbid depression.

    CAS  PubMed  PubMed Central  Google Scholar 

  80. O’Connor CM, Jiang W, Kuchibhatla M, Silva SG, Cuffe MS, Callwood DD, et al. Safety and efficacy of sertraline for depression in patients with heart failure: results of the SADHART-CHF (Sertraline Against Depression and Heart Disease in Chronic Heart Failure) trial. J Am Coll Cardiol. 2010;56:692–9.

    PubMed  PubMed Central  Google Scholar 

  81. •• Angermann CE, Gelbrich G, Stork S, Gunold H, Edelmann F, Wachter R, et al. Effect of escitalopram on all-cause mortality and hospitalization in patients with heart failure and depression: the MOOD-HF randomized clinical trial. JAMA. 2016;315:2683–93 This study is the first long-term randomized controlled trial of SSRI therapy in heart failure patients with comorbid depression.

    CAS  PubMed  Google Scholar 

  82. Freedland KE, Carney RM, Rich MW, Steinmeyer BC, Rubin EH. Cognitive behavior therapy for depression and self-care in heart failure patients: a randomized clinical trial. JAMA Intern Med. 2015;175:1773–82.

    PubMed  PubMed Central  Google Scholar 

  83. Huffman JC, Mastromauro CA, Beach SR, Celano CM, DuBois CM, Healy BC, et al. Collaborative care for depression and anxiety disorders in patients with recent cardiac events: the Management of Sadness and Anxiety in Cardiology (MOSAIC) randomized clinical trial. JAMA Intern Med. 2014;174:927–35.

    CAS  PubMed  Google Scholar 

  84. Blumenthal JA, Babyak MA, O’Connor C, Keteyian S, Landzberg J, Howlett J, et al. Effects of exercise training on depressive symptoms in patients with chronic heart failure: the HF-ACTION randomized trial. JAMA. 2012;308:465–74.

    CAS  PubMed  PubMed Central  Google Scholar 

  85. Tu RH, Zeng ZY, Zhong GQ, Wu WF, Lu YJ, Bo ZD, et al. Effects of exercise training on depression in patients with heart failure: a systematic review and meta-analysis of randomized controlled trials. Eur J Heart Fail. 2014;16:749–57.

    PubMed  Google Scholar 

  86. Taylor CB, Youngblood ME, Catellier D, Veith RC, Carney RM, Burg MM, et al. Effects of antidepressant medication on morbidity and mortality in depressed patients after myocardial infarction. Arch Gen Psychiatry. 2005;62:792–8.

    CAS  PubMed  Google Scholar 

  87. Glassman AH, Bigger JT Jr, Gaffney M. Psychiatric characteristics associated with long-term mortality among 361 patients having an acute coronary syndrome and major depression: seven-year follow-up of SADHART participants. Arch Gen Psychiatry. 2009;66:1022–9.

    PubMed  Google Scholar 

  88. Jorge RE, Robinson RG, Arndt S, Starkstein S. Mortality and poststroke depression: a placebo-controlled trial of antidepressants. Am J Psychiatry. 2003;160:1823–9.

    PubMed  Google Scholar 

  89. Angermann CE, Deckert J, Ertl G. Escitalopram and outcomes among patients with depression and heart failure-reply. JAMA. 2016;316:1494–5.

    PubMed  Google Scholar 

  90. Jiang W, Oken H, Fiuzat M, Shaw LK, Martsberger C, Kuchibhatla M, et al. Plasma omega-3 polyunsaturated fatty acids and survival in patients with chronic heart failure and major depressive disorder. J Cardiovasc Transl Res. 2012;5:92–9.

    PubMed  Google Scholar 

  91. Appleton KM, Rogers PJ, Ness AR. Updated systematic review and meta-analysis of the effects of n-3 long-chain polyunsaturated fatty acids on depressed mood. Am J Clin Nutr. 2010;91:757–70.

    CAS  PubMed  Google Scholar 

  92. Tavazzi L, Maggioni AP, Marchioli R, Barlera S, Franzosi MG, Latini R, et al. Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial. Lancet. 2008;372:1223–30.

    PubMed  Google Scholar 

  93. Su K-P, Tseng P-T, Lin P-Y, Okubo R, Chen T-Y, Chen Y-W, et al. Association of use of omega-3 polyunsaturated fatty acids with changes in severity of anxiety symptoms. JAMA Netw Open 2018; 14 Sep [Epub ahead of print].

  94. •• Hedayati SS, Gregg LP, Carmody T, Jain N, Toups M, Rush AJ, et al. Effect of sertraline on depressive symptoms in patients with chronic kidney disease without dialysis dependence: the CAST randomized clinical trial. JAMA. 2017;318:1876–90 This study is the first randomized controlled trial of treatment with an SSRI in patients with chronic renal disease and comorbid depression.

    CAS  PubMed  PubMed Central  Google Scholar 

  95. Walther CP, Shah AA, Winkelmayer WC. Treating depression in patients with advanced CKD: beyond the generalizability frontier. JAMA. 2017;318:1873–4.

    PubMed  Google Scholar 

  96. Gary RA, Dunbar SB, Higgins MK, Musselman DL, Smith AL. Combined exercise and cognitive behavioral therapy improves outcomes in patients with heart failure. J Psychosom Res. 2010;69:119–31.

    PubMed  PubMed Central  Google Scholar 

  97. Groot C, Hooghiemstra AM, Raijmakers PG, van Berckel BN, Scheltens P, Scherder EJ, et al. The effect of physical activity on cognitive function in patients with dementia: a meta-analysis of randomized control trials. Ageing Res Rev. 2016;25:13–23.

    CAS  PubMed  Google Scholar 

  98. Smith PJ, Blumenthal JA, Hoffman BM, Cooper H, Strauman TA, Welsh-Bohmer K, et al. Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosom Med. 2010;72:239–52.

    PubMed  PubMed Central  Google Scholar 

  99. Zheng G, Xia R, Zhou W, Tao J, Chen L. Aerobic exercise ameliorates cognitive function in older adults with mild cognitive impairment: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med. 2016;50:1443–50.

    PubMed  Google Scholar 

  100. Wenger NK. Current status of cardiac rehabilitation. J Am Coll Cardiol. 2008;51:1619–31.

    PubMed  Google Scholar 

  101. Perez-Lopez FR, Martinez-Dominguez SJ, Lajusticia H, Chedraui P, Health Outcomes Systematic Analyses P. Effects of programmed exercise on depressive symptoms in midlife and older women: a meta-analysis of randomized controlled trials. Maturitas 2017;106:38–47.

    PubMed  Google Scholar 

  102. Gunold H, Angermann CE. Kognitive Dysfunktion, Depression und Angst bei Herzinsuffizienz. Aktuel Kardol. 2015;4:379–86.

    Google Scholar 

  103. Jaarsma T, van der Wal MH, Lesman-Leegte I, Luttik ML, Hogenhuis J, Veeger NJ, et al. Effect of moderate or intensive disease management program on outcome in patients with heart failure: Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH). Arch Intern Med. 2008;168:316–24.

    PubMed  Google Scholar 

Download references

Acknowledgments

With permission of the publisher, this article is an updated and extended version of a chapter included in Cardv. Med., David S. Feldman and Paul Mohacsi (Eds): Heart Failure, 978-3-319-98182-6, 335068_1_En, (Chapter 13, Wallenborn J, Angermann CEA. Psychological Comorbidities in Heart Failure). Springer Nature 2018.

Author information

Authors and Affiliations

  1. Department of Internal Medicine I and Comprehensive Heart Failure Center, University and University Hospital of Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany

    Christiane E. Angermann & Georg Ertl

Authors
  1. Christiane E. Angermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Georg Ertl
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christiane E. Angermann.

Ethics declarations

Conflict of Interest

The authors declare no conflicts of interest.

Christiane E. Angermann is a section editor of Current Heart Failure Reports.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Comorbidities of Heart Failure

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Angermann, C.E., Ertl, G. Depression, Anxiety, and Cognitive Impairment. Curr Heart Fail Rep 15, 398–410 (2018). https://doi.org/10.1007/s11897-018-0414-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11897-018-0414-8

Keywords

Search

Navigation