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. 2019 Oct:125:109811.
doi: 10.1016/j.jpsychores.2019.109811. Epub 2019 Aug 14.

Emotion regulation in patients with heart failure: Its relationship with depressive symptoms and rehospitalization

Mira-Lynn Chavanon  1 , Thomas Meyer  2 , Birgit Herbeck Belnap  3 , Yan Huang  4 , Kaleab Z Abebe  5 , Bruce L Rollman  6 , Christoph Herrmann-Lingen  7
Affiliations

Emotion regulation in patients with heart failure: Its relationship with depressive symptoms and rehospitalization

Mira-Lynn Chavanon et al. J Psychosom Res. 2019 Oct.

Abstract

Objective: To examine the role of emotion regulation and its relationship to mental and physical health in patients with heart failure (HF).

Methods: Patients hospitalized with HF were screened for depressive symptoms with the two-item Patient Health Questionnaire (PHQ-2) and classified as screen-positive if endorsing ≥1 item and otherwise as screen-negative. One month after hospital discharge, the Emotion Regulation Questionnaire (ERQ) was administered to assess suppression and reappraisal as emotion regulation strategies. In all participants who completed the ERQ (N = 394), all-cause rehospitalization and depressive symptoms using the PHQ-9 were assessed at 1-, 3-, and 6-months after hospital discharge.

Results: Overall, PHQ-9 scores decreased by 6-months (-0.13 points/month, p = .003), and although suppression showed a small association with depression, neither strategy modulated the slope of the decline in depressive symptoms. Multivariable-adjusted Cox models showed that reappraisal and suppression were not related to all-cause rehospitalization in the entire cohort. However, increasing reappraisal reduced rehospitalization risk by 24% for screen-positive patients (N = 311, HR = 0.76, p = .02), but increased it by 94% in screen-negative patients (N = 83, HR = 1.94, p = .009).

Conclusion: Suppression and reappraisal showed specific and divergent associations in patients with HF: Suppression may relate to depressive symptoms. Reappraisal was associated with rehospitalization, but differently for patients with a positive vs. negative depression screen. Further studies are needed to examine whether emotion-regulation skill training can improve mental and physical health in depressed patients with HF or ameliorate depression in those at-risk.

Keywords: Depression; Emotion regulation; Heart failure; Rehospitalization.

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Conflict of interest statement

Conflict of Interest: Unrelated to this publication, CHL has received royalties from Hogrefe-Huber publishers, Berne, Switzerland, lecture honoraria from Servier, Heel, and Novartis and an honorarium from Pfizer for serving on an advisory board. None of the other authors have any financial disclosures or potential conflicts of interest to report.

Figures

Figure 1:
Figure 1:
Diagram showing the flow of participants through the trial
See this image and copyright information in PMC

References

    1. Ponikowski P, Anker SD, AlHabib KF, Cowie MR, Force TL, Hu S, Jaarsma T, Krum H, Rastogi V, Rohde LE, Samal UC, Shimokawa H, Budi Siswanto B, Sliwa K, Filippatos G, Heart failure: preventing disease and death worldwide, ESC Heart Fail 1(1) (2014) 4–25. - PubMed
    1. Hare D, Toukhsati S, Johansson P, Jaarsma T, Depression and cardiovascular disease: a clinical review, European Heart Journal 35(21) (2014) 1365–U13. - PubMed
    1. Gathright E, Goldstein C, Josephson R, Hughes J, Depression increases the risk of mortality in patients with heart failure: A meta-analysis, Journal of Psychosomatic Research 94 (2017) 82–89. - PMC - PubMed
    1. Rutledge T, Reis V, Linke S, Greenberg B, Mills P, Depression in heart failure - A meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes, Journal of the American College of Cardiology 48(8) (2006) 1527–1537. - PubMed
    1. Rollman BL, Herbeck Belnap B, Mazumdar S, Houck PR, He F, Alvarez RJ, Schulberg HC, Reynolds CF, McNamara DM, A positive 2-item Patient Health Questionnaire depression screen among hospitalized heart failure patients is associated with elevated 12-month mortality, J Card Fail 18(3) (2012) 238–45. - PMC - PubMed

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