IJCS | Volume 31, Nº4, July / August 2018

420 Guerra et al. Screening: depression in heart failure Int J Cardiovasc Sci. 2018;31(4)414-421 Original Article 1) depression has a relevant prevalence in outpatients with HF; 2) the diagnosis and detection of depression are obtained through the use of questionnaires in outpatients with HF; 3) the three questionnaires evaluated have a superficial agreement and moderate consistency in the diagnosis of depression in the population with HF; 4) the HAM-D scale proved to be the best instrument in diagnosing depression, since it showed greater accuracy and sensitivity, and a lower percentage of false-negative results; 5) the PHQ-9 instrument was conservative in diagnosing depression, with a high percentage of false- negative results and low sensitivity to identify patients who are in fact depressed. In the present study, the HAM-D questionnaire showed greater accuracy in the diagnosis of depression, due to its convenience in grading this condition and for demonstrating (in several studies) the ability to evaluate the severity of the depression. These conclusions identify areas with gaps requiring further research, in addition to new questions in the screening of depression, and adds more information on the prevalence of depression in HF, guiding researchers and clinicians in terms of screening for depression and issues relevant to the association of these two pathologies, depression and HF. Author contributions Conception and design of the research: Guerra TRB, Mendlowicz MV, Mesquita ET, Cavalcanti ACD; Acquisition of data: Guerra TRB, Venancio ICD, Pinheiro DMM; Analysis and interpretation of the data: Guerra TRB, Mesquita ET, Cavalcanti ACD; Statistical analysis: Guerra TRB; Obtaining financing: Mesquita ET, Cavalcanti ACD; Writing of the manuscript: Guerra TRB, Pinheiro DMM; Critical revision of the manuscript for intellectual content: Mendlowicz MV, Mesquita ET, Cavalcanti ACD. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by CAPES and CNPq. Study Association This article is part of the thesis of Doctoral submitted by Thais de Rezende Bessa Guerra, from Universidade Federal Fluminense . Ethics approval and consent to participate This study was approved by the Ethics Committee of the Hospital Universitário Antônio Pedro under the protocol number 630.078. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 1. Matias AGC, Fonsêca MA, Gomes MLF, Matos MAA. Indicadores de depressão em idosos e os diferentes métodos de rastreamento. Einstein. 2016 Jan/Mar;14(1):6-11. 2. Bocchi EA, Marcondes-Braga FG, Bacal F, Ferraz AS, Albuquerque D, Rodrigues D, et al. Sociedade Brasileira de Cardiologia. Atualização da Diretriz Brasileira de Insuficiência Cardíaca Crônica. Arq Bras Cardiol. 2012 Jan;98(1 supl. 1):1-33. 3. Aguiar VB, Ochiai ME, Cardoso JN, Carlo CHD, Morgado PC, Munhoz RT et al. Relação entre depressão, nível de BNP e comprometimento ventricular na insuficiência cardíaca. Arq Bras Cardiol. 2010 Dez;96(6):732-7. 4. Altay H, Zorlu A, Kocum HT, Demircan S, Yilmaz N, Yilmaz MB. Relationship between parathyroid hormone and depression in heart failure. Arq Bras Cardiol. 2012 Oct;99(4):915-23. 5. Faller H, Störk S, Gelbrich G, Schowalter M, Ertl G, Angermann CE. Depressive symptoms in heart failure: Independent prognostic factor or marker of functional status? J Psychosom Res. 2015 Jun;78(6):569-72. 6. Sokoreli I, de Vries JJ, Riistama JM, Pauws SC, Steyerberg EW, Tesanovic A et al. Depression as an independent prognostic factor for all-cause mortality after a hospital admission for worsening heart failure. Int J Cardiol. 2016 Oct;220:202-7. 7. Gottlieb SS, Khatta M, Friedmann E, Einbinder L, Katzen S, Baker B, et al. The influence of age, gender, and race on the prevalence of depression in heart failure patients. J Am Coll Cardiol. 2004 May;43(9):1542-9. 8. Lossnitzer N, Herzog W, Störk S, Wild B, Müller-Tasch T, Lehmkuhl E, et al. Incidence rates and predictors of major and minor depression in patients with heart failure. Int J Cardiol. 2013 Jul;167(2):502-7. 9. Tier CG, Santos SSC, Pelzer MT, BulhosaMS. (2007). Escalas de avaliação da depressão em idosos. Rev Baiana de Enferm. 2007Mai/Dez;21(2-3):27- 36. 10. ArosMS, Yoshida EMP. Estudos da depressão: Instrumentos de avaliação e gênero. Bol Psicol. 2009 Jun;59(130)61-76. 11. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960 Feb;23:56-62. References