Luo YT, Ou AZ, Lin DS, Li H, Zhou F, Liu YM, Ye XP, Deng X. Status of anxiety and depression among chronic heart failure patients: Factors influencing poor fluid restriction adherence. World J Psychiatry 2025; 15(6): 103765 [DOI: 10.5498/wjp.v15.i6.103765]
Corresponding Author of This Article
Xu Deng, MD, Preventive Treatment Center, The First Hospital of Hunan University of Traditional Chinese Medicine, No. 95 Shaoshan Middle Road, Changsha 410007, Hunan Province, China. dengxu399@163.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. Jun 19, 2025; 15(6): 103765 Published online Jun 19, 2025. doi: 10.5498/wjp.v15.i6.103765
Status of anxiety and depression among chronic heart failure patients: Factors influencing poor fluid restriction adherence
Yun-Tao Luo, Ai-Zhi Ou, Di-Sha Lin, Hong Li, Fang Zhou, Yue-Mei Liu, Xin-Ping Ye, Xu Deng
Yun-Tao Luo, Ai-Zhi Ou, Di-Sha Lin, Hong Li, Fang Zhou, Xin-Ping Ye, Department of Health Management, The First Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410007, Hunan Province, China
Yue-Mei Liu, Department of Cardiology, The First Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410007, Hunan Province, China
Xu Deng, Preventive Treatment Center, The First Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410007, Hunan Province, China
Author contributions: Luo YT designed the study; Luo YT, Ou AZ, Lin DS, Li H, Zhou F, Liu YM, Ye XP and Deng X collected the data; Luo YT and Deng X analyzed the data; Luo YT prepared the manuscript; all authors read and approved the final manuscript.
Supported by Huxiang TCM Physique Intervention Clinical Research Center, No. 2023SK4061; Traditional Chinese Medicine Research Project of Hunan Province, No. B2023065; Hunan Province "14th Five-Year Plan" key specialty of TCM, No. [2023] 4; Hunan University of Chinese Medicine and Hospital Joint Foundation, No. 2023XYLH019 and 2024XYLH365; R & D Plan for Key Areas of Hunan Provincial Department of Science and Technology, No. 2019SK2321; Excellent Youth Program of Hunan Education Department, No. 24B0346; Hunan Provincial Natural Science Foundation for Young Scientists, No. 2025JJ60626.
Institutional review board statement: This study was approved by the Ethic Committee of The First Hospital of Hunan University of Traditional Chinese Medicine.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xu Deng, MD, Preventive Treatment Center, The First Hospital of Hunan University of Traditional Chinese Medicine, No. 95 Shaoshan Middle Road, Changsha 410007, Hunan Province, China. dengxu399@163.com
Received: February 26, 2025 Revised: March 27, 2025 Accepted: April 15, 2025 Published online: June 19, 2025 Processing time: 92 Days and 2.2 Hours
Abstract
BACKGROUND
Anxiety and depression are prevalent among patients with chronic heart failure (CHF) and can adversely contribute to treatment adherence and clinical outcomes. Poor fluid restriction adherence is a widespread challenge in the management of CHF. To effectively manage disease progression and alleviate symptoms, it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.
AIM
To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.
METHODS
Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study. Questionnaires, including the Psychosomatic Symptom Scale, Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Fluid Restriction Adherence Questionnaire were administered to patients. Based on their anxiety and depression scores, patients were categorized into anxiety/depression and non-anxiety/depression groups, as well as fluid restriction adherence and fluid restriction non-adherence groups. General patient data were collected, and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety. Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.
RESULTS
Statistically significant differences in age, New York Heart Association (NYHA) grading, marital status, educational attainment, and family support were observed between depressed and non-depressed CHF patients (P < 0.05). Age, NYHA grading, marital status, educational attainment, and family support were identified as factors influencing the development of depression. The anxiety and non-anxiety groups differed statistically in terms of gender, age, NYHA grading, smoking history, alcohol consumption history, monthly income, educational attainment, and family support (P < 0.05). Gender, smoking, alcohol consumption, monthly income, and educational attainment affected anxiety in these patients. The fluid restriction adherence rate was 28.0%, and thirst sensation, anxiety, and depression were identified as independent influencing factors.
CONCLUSION
CHF patients are susceptible to anxiety and depression, with multiple associated influencing factors. Moreover, anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.
Core Tip: In this study, the prevalence of depression and anxiety among 300 patients with chronic heart failure was 30.0% and 43.3%, respectively. Depression was independently influenced by several factors, including age, New York Heart Association classification, marital status, educational attainment, and family support. Alternatively, anxiety was independently affected by gender, smoking status, alcohol consumption, monthly income level, and educational level. Only 28.0% of the patients demonstrated fluid restriction adherence, which was independently determined by thirst sensation, anxiety, and depression. These findings may enhance the identification and management of patients at high risk for depression, anxiety, and non-adherence to fluid restrictions. Implementing targeted interventions, including thirst management, psychological support, and health education, for these high-risk patients can improve their psychological well-being and treatment compliance, ultimately enhancing therapeutic efficacy and prognosis.
