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Depression screening in heart failure – prognosis impact of depressive symptoms assessed by the PHQ9
Session:
Sessão de Posters 32 - Comportamento, mente e metabolismo
Speaker:
Raquel Montalvão
Congress:
CPC 2026
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.10 Depression and Heart Disease
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Raquel Montalvão; Joana Pereira; Maria Inês Soares; Mariana Ramos; Margarida Matias; João Presume; Inês Araújo; Cândida Fonseca
Abstract
<p><strong>Background:</strong> The coexistence of cardiovascular disease and mental health disorders may have synergistic effects, worsening both psychological well-being and cardiovascular prognosis. Depression is a prevalent comorbidity in heart failure (HF) patients and is associated with increased mortality and morbidity. Current European HF guidelines and mental health consensus recommend addressing depression using questionnaires, including the Patient Health Questionnaire-9 (PHQ-9), which is a 9-item questionnaire that can be self-administered in less than 3 minutes. </p> <p><strong>Objectives:</strong> To evaluate the use of PHQ-9 in a Portuguese cohort of HF patients as a practical approach for the screening and management of depression in patients with HF. </p> <p><strong>Methods:</strong> A prospective study was conducted, enrolling consecutive patients followed at a heart failure clinic over a period of 3 months. Patients answered the PHQ-9 before the appointment. During the visits, physicians evaluated the results and managed depression according to the study protocol (figure 1). The severity of depression was evaluated by PHQ-9 at baseline. Outcome at 90-day follow-up included serum NT-proBNP levels, HF symptom severity assessed by the NYHA classification, and a composite endpoint of all-cause mortality and HF exacerbation. </p> <p><strong>Results:</strong> Of the 124 included patients, 84 (68%) were male and the mean age was 74 (12) years. The majority of patients (82%) had a NYHA class of I or II and 48% had preserved ejection fraction. There were 29 patients (23%) with a previous diagnosis of depression and on antidepressants. After the evaluation of PHQ-9, 52% (n=65), 27% (n=33), 10% (n=12), 8% (n=10) and 3% (n=4) had minimal, mild, moderate, moderately severe, and severe depression symptoms, respectively. Of the patients without previous depression diagnosis, 49% (n=46) had at least mild depressive symptoms. The presence of depressive symptoms was associated with higher levels of serum NT-proBNP (r=0.31; p<0.001) and worse HF symptoms (p<0,001). Over a mean follow-up of 152 (27) days, patients who met the composite outcomes (death or HF exacerbation) had a significantly higher PHQ-9 score (10 ± 7 vs. 5 ± 5; p<0,001). </p> <p><strong>Conclusions:</strong> This study confirmed the high prevalence of depressive symptoms in a real-world cohort of HF patients and that screening for depression can be efficiently integrated in the HF consultation. A higher burden of depressive symptoms was associated with higher serum NT-proBNP levels, more severe symptoms and higher incidence of all-cause mortality or heart failure hospitalization. These findings support the importance of routine depression assessment to improve prognosis in heart failure management. </p>
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