Depressed Patients Understand Heart Failure Prognosis but Not How to Control It

Background: Depression prevalence in patients with heart failure (HF) is 21% to 42%. Conceptual illness beliefs that patients have about HF may be associated with depression.

Methods: We examined whether accuracy of illness beliefs was associated with depression. Illness belief scores were compared with depression severity, and multivariable analyses were performed to determine factors that were independently associated with depression.

Results: In 219 elderly patients with HF, depression prevalence was 47%. Accuracy of illness beliefs was associated with depression (r = .224; P = .049), due solely to accuracy of beliefs about consequences of HF (P = .005). Beliefs about how to control HF remained stable as depression severity increased. After controlling for significant univariable factors, mean illness belief and consequence scores remained associated with depression.

Conclusion: In this sample, accuracy of beliefs about HF consequences increased but beliefs about how to control HF remained unchanged as depression severity worsened. This combination of HF beliefs may influence coping through self-care behaviors.