Caspian Journal of Internal Medicine
Babol University of Medical Sciences
Wed, Sep 9, 2026
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Volume 17, Issue 3 (Summer 2026)
Caspian J Intern Med 2026, 17(3): 603-612 |
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hamzehpour R, Zieaie Amiri N, Ghanbarzadeh M, Hamidia A, Javadian Kotnaei S, Khoozan M, et al . Depressive symptoms and related factors in adults with heart failure: A multicenter cross-sectional study in northern Iran (2022–2023). Caspian J Intern Med 2026; 17 (3) :603-612
URL: http://caspjim.com/article-1-4920-en.html
URL: http://caspjim.com/article-1-4920-en.html
Romina Hamzehpour * 
, Naghmeh Zieaie Amiri , Milad Ghanbarzadeh , Angela Hamidia , Sakine Javadian Kotnaei , Mahboobeh Khoozan , Shirafkan Hoda , Mahasti Emami Hamzehkolaee
, Naghmeh Zieaie Amiri , Milad Ghanbarzadeh , Angela Hamidia , Sakine Javadian Kotnaei , Mahboobeh Khoozan , Shirafkan Hoda , Mahasti Emami Hamzehkolaee
Social Determinants of Health Research Center Health Research Institute, Babol University of Medical Sciences, Babol, Iran , r.hamzehpour@mubabol.ac.ir
Abstract: (9 Views)
Background: Depressive symptoms are frequent in patients with heart failure (HF), but estimates vary across settings. Clarifying their burden and related factors can inform integrated care. This study aimed to estimate the prevalence of depressive symptoms in adults with HF and identify associated factors.
Methods: We conducted a multicenter cross-sectional study (June 2022–February 2023) in cardiology wards and outpatient clinics of three hospitals affiliated with Babol University of Medical Sciences, northern Iran. Consecutive adults (≥18 years) with cardiologist-confirmed HF completed the 17-item Hamilton Depression Rating Scale (HAM-D-17); a score >7 was considered indicative of clinically relevant depressive symptoms. Baseline demographic and clinical characteristics were recorded. Independent correlates of depressive symptoms were examined using multivariable logistic regression.
Results: Of 250 participants (mean age 60.3±15.1 years; 46.4% women), 51 (20.4%) had depressive symptoms (HAM-D-17 >7): mild 18.4%, moderate 1.6%, severe 0.4%. In unadjusted analyses, depressive symptoms were more common in women, in unemployed and unmarried participants, and in those with more advanced New York Heart Association (NYHA) functional class. In multivariable models, female sex (OR 6.57, 95% CI 2.91–14.85) and higher NYHA class were associated with depressive symptoms (p<0.01), whereas left ventricular ejection fraction and HF etiology were not.
Conclusion: Approximately one fifth of adults with HF had clinically relevant depressive symptoms, particularly women and patients with worse functional status. Routine screening and integrated psychosocial care should be incorporated into HF management, with special attention to patients in advanced NYHA classes.
Methods: We conducted a multicenter cross-sectional study (June 2022–February 2023) in cardiology wards and outpatient clinics of three hospitals affiliated with Babol University of Medical Sciences, northern Iran. Consecutive adults (≥18 years) with cardiologist-confirmed HF completed the 17-item Hamilton Depression Rating Scale (HAM-D-17); a score >7 was considered indicative of clinically relevant depressive symptoms. Baseline demographic and clinical characteristics were recorded. Independent correlates of depressive symptoms were examined using multivariable logistic regression.
Results: Of 250 participants (mean age 60.3±15.1 years; 46.4% women), 51 (20.4%) had depressive symptoms (HAM-D-17 >7): mild 18.4%, moderate 1.6%, severe 0.4%. In unadjusted analyses, depressive symptoms were more common in women, in unemployed and unmarried participants, and in those with more advanced New York Heart Association (NYHA) functional class. In multivariable models, female sex (OR 6.57, 95% CI 2.91–14.85) and higher NYHA class were associated with depressive symptoms (p<0.01), whereas left ventricular ejection fraction and HF etiology were not.
Conclusion: Approximately one fifth of adults with HF had clinically relevant depressive symptoms, particularly women and patients with worse functional status. Routine screening and integrated psychosocial care should be incorporated into HF management, with special attention to patients in advanced NYHA classes.
Keywords: Heart failure, Depression, HAM-D-17, DSM-5, NYHA functional class, Iran Cross-sectional study
Policy Brief: Original Article |
Subject:
Cardiology
Received: 2025/09/17 | Accepted: 2026/02/8 | Published: 2026/06/9
Received: 2025/09/17 | Accepted: 2026/02/8 | Published: 2026/06/9
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