Relationship between psychological profile and cardiological variables in chronic heart failure - The role of patient subjectivity

Aim To analyse the relationships between the psychological profile, the sat isfaction profile and cardiological variables in patients with chronic hear t failure. Material and Methods One hundred and fifty-two male patients with chronic h eart failure in a stable clinical condition underwent cardiological evaluat ion and psychological assessment by means of two instruments: the Cognitive Behavioural Assessment 2.0 Battery and the Satisfaction Profile. Results Patients scored higher than healthy subjects in terms of psychophys iological disorders and depression. Patients in NYHA class III reported hig her anxiety and depression scores and had more frequent problems in daily l ife than patients in NYHA classes I and II. Class III patients also reporte d lower satisfaction levels in many aspects of psychological and physical f unctioning. Pulmonary resistances >2.5 Wood units, pulmonary capillary wedg e pressure >0.18 mmHg and a diagnosis of ischaemic cardiomyopathy were asso ciated with low satisfaction levels in the Satisfaction Profile 'physical f unctioning' factor. To be listed for heart transplantation and a history of more than three hospitalizations were related to low satisfaction levels i n many items of the Satisfaction Profile. Finally, stepwise multiple regres sion showed that NYHA class, depression score and pulmonary capillary resis tance accounted for 32% of the variance in the Satisfaction Profile physica l functioning factor score. Conclusion On the basis of chronic heart failure diagnosis only, a generic pattern of psychological distress can be predicted, common to many severe c hronic diseases. Shifting from objective mental health measures towards the domain of subjective satisfaction, the only link which emerges is between objective cardiological data and satisfaction with physical functioning. Sa tisfaction in terms of other life aspects does not seem to be related to ca rdiological variables. These results support the importance of subjectivity in health related quality of life, as well as objective measures. (C) 1999 The European Society of Cardiology.