The Management of Patients with Heart Failure and Depression: a Systematic Review

Background: Heart failure (HF) is a chronic and incapacitant disease with bad prognosis, and it is commonly related to psychosocial comorbidities that difficult treatment adhesion. The prevalence of depression in HF varies from 20 to 40%, occurring 3 to 5 times more frequently in patients with HF than general population. The coexistence of depressive symptoms depreciates heart condition in patients with HF: depressive symptoms predict mortality, re-hospitalization, and an augment of symptoms in those patients. Aiming to clarify certain aspects of this comorbidity, it was performed a systematic review using Scopus and MEDLINE/PubMed databases, correlating HF and depression, from January 1, 2013, to August 20, 2017, by means of the descriptors found in MeSH: “heart failure” and "depression". Methods:Data screening applied combinations, as follows: #1. “Heart Failure” [MeSH Terms]; #2. “Depression” [MeSH Terms]; #3. “Management” [Keyword], using the following research strategy: (#1 AND #2) AND #3. Results:Improvement in depression levels through interventions using telephone is extensively reported in literature, based on providing information about the disease, self-care accompaniment, or cognitive behavioral therapy (CBT). Because of this, it is shown as an effective alternative in depression, improving surviving rates. Equally effective interventions were the empowering of the patient and the familial engagement in caring, palliative care and multidisciplinary participation in construction of caring program. Conclusions: Curiously, physical exercises did not show, statistically, efficiency in depression improvement, and few were the articles approaching antidepressant medications use in this class of patient.