Depression in paroxysmal and persistent atrial fibrillation patients: a cross-sectional comparison of patients enroled in two large clinical trials

Europace. 2014 Jun;16(6):812-9. doi: 10.1093/europace/eut361. Epub 2013 Dec 18.

Abstract

Aims: Despite its high clinical relevance, few studies have investigated depression in patients with atrial fibrillation (AF). We aimed to assess whether depressed mood was more common in persistent or paroxysmal AF patients in controlled models and report frequencies of major depressive disorder.

Methods and results: Cross-sectional data from two contemporary clinical trials were used to compare paroxysmal (n = 310) and persistent (n = 392) AF patients' depressed mood severity (measured by the Major Depression Inventory) with each trial including only one patient type. A four-category outcome of depressed mood severity was chosen as exposure variable. Ordinal logistic regression was applied to analyse the association of AF type with depressed mood in a crude model and a confounder control model. In the study sample, 8.4% were classified as having major depressive disorder [10.5% of persistent and 5.8% of paroxysmal patients; odds ratio (OR) = 1.89; 95% confidence interval (CI): 1.07-3.37], according to the diagnostic and statistical manual of mental disorders [(diagnostic and statistical manual of mental disorders (DSM-IV)] criteria. In both the age and sex adjusted crude model and in the confounder control model, the association of persistent AF with more severe depressed mood was significant (OR confounder controlled model = 1.44; 95% CI: 1.13-1.75, P = 0.007).

Conclusion: Persistent AF patients may suffer from more severe depressed mood than paroxysmal AF patients with similar symptom burden after controlling for relevant factors.

Trial registration: ClinicalTrials.gov NCT00098137.

Keywords: Atrial fibrillation; Depression; Mental health; Prevalence.

Publication types

  • Comparative Study
  • Controlled Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Arrhythmia Agents / therapeutic use
  • Atrial Fibrillation / drug therapy
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / psychology*
  • Causality
  • Chronic Disease
  • Clinical Trials as Topic*
  • Comorbidity
  • Cross-Sectional Studies
  • Depression / drug therapy
  • Depression / epidemiology*
  • Depression / psychology*
  • Depressive Disorder, Major / epidemiology*
  • Depressive Disorder, Major / psychology*
  • Depressive Disorder, Major / therapy
  • Evidence-Based Medicine
  • Female
  • Germany / epidemiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Risk Factors
  • Treatment Outcome

Substances

  • Anti-Arrhythmia Agents

Associated data

  • ClinicalTrials.gov/NCT00098137