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Editor's Correspondence
February 11, 2002

Depression and Major Outcomes in Older Patients With Heart Failure—Reply

Arch Intern Med. 2002;162(3):363. doi:

In reply

We are grateful for the support from Dr Rozzini and his colleagues and Dr Friedman for our recently published study suggesting that depression is an independent risk factor for increased mortality and rehospitalization in HF. The results of the study by Dr Rozzini et al not only duplicated our findings, but uniquely demonstrated further that the self-administered GDS in the elderly population is a sensitive tool to assess the negative prognostic effects of depression in patients with HF. Vaccarino et al1 reported that depression, defined as a GDS score of 5 or higher, is associated with a higher degree of functional decline but not with mortality independently from multiple physical conditions. The findings of Rozzini et al from a sample of 800 patients eliminated the concern that GDS may not be equivalent to a clinical diagnosis of depression through standard diagnostic interview. All studies so far have presented only short-term (≤12 months) adverse effects of depression in HF. We hope to learn from these investigators whether the adverse effects of depression in HF persist over a longer duration (eg, 3-5 years).

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