Depression is a major concern with heart failure patients. The potentially devastating physical limitations imposed on them often result in highly negative changes in their quality of life.
In the general population, women tend to suffer from depression twice as often as men, and are more likely to suffer from severe depressive episodes with functional impairment . The same ratio appies to heart failure patients
So the question is: do those heart failure patients who end up depressed, do so because they are suffering from more serious health problems? Or, do they simply perceive their health to be worse than others?
One study tested this hypothesis . They took a depressed group of patients who perceived their physical limitations to be worse than other HF patients and subjected them to an exercise stress test where they monitored energy expenditure and LVEF. It turned out that the depressed group of patients had a superior LVEF and showed less signs of exertion.
This study suggests that it is important to consider the idea that a patient’s perception of his/her health is equally as, or even more important than, their actual physiological health in determining the severity of their depression and their overall quality of life. Also, physicians should be aware that this artificially severe health perception can lead to diagnostic errors.
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