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Depressive symptoms and spiritual wellbeing in asymptomatic heart failure patients

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Abstract

Depression adversely predicts prognosis in individuals with symptomatic heart failure. In some clinical populations, spiritual wellness is considered to be a protective factor against depressive symptoms. This study examined associations among depressive symptoms, spiritual wellbeing, sleep, fatigue, functional capacity, and inflammatory biomarkers in 132 men and women with asymptomatic stage B heart failure (age 66.5 years ± 10.5). Approximately 32 % of the patients scored ≥10 on the Beck Depression Inventory, indicating potentially clinically relevant depressive symptoms. Multiple regression analysis predicting fewer depressive symptoms included the following significant variables: a lower inflammatory score comprised of disease-relevant biomarkers (p < 0.02), less fatigue (p < 0.001), better sleep (p < 0.04), and more spiritual wellbeing (p < 0.01) (overall model F = 26.6, p < 0.001, adjusted R square = 0.629). Further analyses indicated that the meaning (p < 0.01) and peace (p < 0.01) subscales, but not the faith (p = 0.332) subscale, of spiritual wellbeing were independently associated with fewer depressive symptoms. Interventions aimed at increasing spiritual wellbeing in patients lives, and specifically meaning and peace, may be a potential treatment target for depressive symptoms asymptomatic heart failure.

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Acknowledgments

This work was supported by Grants HL-073355, HL-096784, and 5UL1 TR000100-05 from the National Institutes of Health.

Conflict of interest

Author Paul J. Mills, Author Kathleen Wilson, Author Navaid Iqbal, Author Fatima Iqbal, Author Milagros Alvarez, Author Meredith A. Pung, Author Katherine Wachmann, Author Thomas Rutledge, Author Jeanne Maglione, Author Sid Zisook, Author Joel Dimsdale, Author Ottar Lunde, Author Barry H. Greenberg, Author Alan Maisel, Author Ajit Raisinghani, Author Loki Natarajan, Author Shamini Jain, Author David J. Hufford, and Author Laura Redwine declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (Forster et al. 2001). Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr. #0804, La Jolla, CA, 92093-0804, USA

    Paul J. Mills, Kathleen Wilson, Milagros Alvarez, Meredith A. Pung, Katherine Wachmann, Thomas Rutledge, Jeanne Maglione, Sid Zisook, Joel E. Dimsdale & Laura Redwine

  2. Samueli Institute, Alexandria, VA, USA

    Paul J. Mills, Shamini Jain & David J. Hufford

  3. Department of Medicine, University of California, San Diego, La Jolla, CA, USA

    Navaid Iqbal, Fatima Iqbal, Ottar Lunde, Barry H. Greenberg, Alan Maisel & Ajit Raisinghani

  4. San Diego VA Health Care System, La Jolla, CA, USA

    Sid Zisook

  5. Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA

    Paul J. Mills & Loki Natarajan

  6. Doctors Kienle Center for Humanistic Medicine, Penn State College of Medicine, Hershey, PA, USA

    David J. Hufford

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Mills, P.J., Wilson, K., Iqbal, N. et al. Depressive symptoms and spiritual wellbeing in asymptomatic heart failure patients. J Behav Med 38, 407–415 (2015). https://doi.org/10.1007/s10865-014-9615-0

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