Risks of Depression and Suicide After Diagnosis With Heart Failure: A National Cohort Study

Authors

Casey Crump
Jan Sundquist
Kenneth S Kendler
Weiva Sieh
Alexis C Edwards
Kristina Sundquist

Publication Date

11-1-2022

Journal

JACC: Heart Failure

Abstract

BACKGROUND: Heart failure (HF) has been associated with psychosocial distress, but other long-term mental health sequelae are unclear.

OBJECTIVES: In this study, the authors sought to determine risks of major depression and suicide, susceptible time periods, and sex-specific differences after HF diagnosis in a large population-based cohort.

METHODS: A national cohort study was conducted of all 154,572 persons diagnosed with HF at ages 18-75 years during 2002-2017 in Sweden and 1,545,720 age- and sex-matched population-based control subjects who were followed up for major depression and suicide ascertained from nationwide inpatient, outpatient, and death records through 2018. Poisson regression was used to compute incidence rate ratios (IRRs) while adjusting for sociodemographic factors and comorbidities.

RESULTS: HF was associated with increased risks of major depression and death by suicide in both men and women, with highest risks in the first 3 months, then declining to modest risks at ≥12 months after HF diagnosis. Within 3 months after HF diagnosis, adjusted IRRs for new-onset major depression were 3.34 (95% CI: 3.04-3.68) in men and 2.78 (95% CI: 2.51-3.09) in women, and for suicide death were 4.47 (95% CI: 2.62-7.62) in men and 2.82 (95% CI: 1.11-7.12) in women. These risks were elevated regardless of age at HF diagnosis. HF was associated with significantly more depression cases in women (P < 0.001).

CONCLUSIONS: In this large national cohort, HF was associated with substantially increased risks of depression and suicide in men and women, with highest risks occurring within 3 months after HF diagnosis. Men and women with HF need timely detection and treatment of depression and suicidality.

Keywords

Male, Humans, Female, Adolescent, Young Adult, Adult, Middle Aged, Aged, Cohort Studies, Heart Failure, Depression, Suicide, Comorbidity, Risk Factors

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Associated Data

PMID: 36328649