Dose-Response Relationship Between Perceived Control and Depression in Patients With Chronic Heart Failure: A Multicenter and Cross-sectional Study.

ABSTRACT

BACKGROUND: Little is known regarding the relationship between perceived control and depression in patients with chronic heart failure (CHF), particularly in terms of their dose-response relationship. OBJECTIVE: The aim of this study was to explore this relationship based on linear and nonlinear hypotheses and potential subgroup differences in patients with CHF. METHODS: A total of 308 patients with CHF were included in the study. Data on perceived control, depression, and relevant covariates, such as gender, age, New York Heart Association classification, and comorbidity burden, were collected. Logistic regression, Spearman correlation, and restricted cubic spline analysis were used for data analysis. RESULTS: Compared with the patients in the first quartiles of perceived control scores (0-16), those in the other 3 quartiles had a lower risk of depression (odds ratios of 0.29, 0.21, and 0.20, respectively; P < .05). Furthermore, a negative correlation between perceived control and depression (r = -0.317, P < .01) was observed. The restricted cubic spline analysis revealed an "L-shaped" curve relationship between perceived control and the presence of depression (P for nonlinear < .01). Compared with patients with a perceived control within the 5th percentile (10 scores), as the perceived control increased, the risk of depression rapidly decreased from "1" until it reached a threshold (20 scores) and stabilized. This trend remained consistent across the subgroups grouped by gender, age, New York Heart Association classification, and comorbidity burden. CONCLUSIONS: Interventions targeting perceived control may hold valuable implications for reducing the risk of depression in patients with CHF, particularly those who have not yet reached the threshold.