Comparison with other chronic diseases
A previous sample of patients on chronic haemodialysis25
showed nearly the same profile as the overall congestive heart
failure sample in our present study. Thus it could be argued
that all chronic disease conditions have a similar impact on
quality of life. However, patients with chronic hepatitis C24
were characterised by quite a different pattern. In scales referring
more to physical health, patients with chronic hepatitis C
resembled patients with congestive heart failure in NYHA
class I. However, in scales referring to mental health, hepatitis
C patients were more comparable to NYHA class II patients.
As expected, patients with major depression were in a better
physical condition than patients with congestive heart
failure. Most interestingly, the patients with congestive heart
failure in NYHA class III had a similar impairment of quality
of life in the mental health domains as patients with major
depression, in addition to their already dramatically reduced
physical health. These data are in accord with the findings of
some recent studies showing that a large proportion of
patients with congestive heart failure suffer from
depression.28–30 Thus the quality of life in patients in NYHA
class III is reduced not only physically but also mentally.
One could speculate that these results reflect the effects of
congestive heart failure on the central nervous system.
Changes in central neurohumoral regulation systems or
diminished central perfusion might impair cognitive capacity
and trigger a latent vulnerability to depressive disorders.