A Positive 2-Item Patient Health Questionnaire Depression Screen Among Hospitalized Heart Failure Patients is Associated With Elevated 12-Month Mortality

Abstract Background Given the association of depression with poorer cardiac outcomes, an American Heart Association Science Advisory has advocated routine screening of cardiac patients for depression using the 2-item Patient Health Questionnaire (PHQ-2) “at a minimum.” However, the prognostic value of the PHQ-2 among HF patients is unknown. Methods and Results We screened hospitalized HF patients (ejection fraction [EF] P ≤ .002); they were similar in other characteristics (65% male, 26% mean EF). At 12 months, 20% of PHQ-2+ versus 8% of PHQ-2− patients had died ( P  = .007) and PHQ-2 status remained associated with both all-cause (hazard ratio [HR] 3.1, 95% confidence interval [CI] 1.4–6.7; P  = .003) and cardiovascular (HR 2.7, 95% CI 1.1–6.6; P  = .03) mortality even after adjustment for age, gender, EF, NYHA functional class, and a variety of other covariates. Conclusions Among hospitalized HF patients, a positive PHQ-2 depression screen is associated with an elevated 12-month mortality risk.