Aikaterini Katsiana

This study investigates the impact of psychiatric interventions on occupational dysfunction in patients with major depressive disorder (MDD) and anxiety disorder (AD). Occupational dysfunction is a significant concern in these populations, severely impairing the ability to perform daily activities and fulfill work and social roles. This research seeks to evaluate how different psychiatric interventions, including pharmacotherapy and psychotherapy, affect patients’ occupational performance and overall quality of life. This study analyzed data from outpatients diagnosed with MDD and AD based on ICD-10 criteria. Participants were assessed before and after intervention using scales that measure anxiety, depression, and occupational task difficulty. Results demonstrated a significant improvement in patients’ ability to perform a wide range of tasks, including personal hygiene, work-related activities, and social engagement, following treatment. The study highlights the importance of a multidisciplinary approach, emphasizing that both pharmacotherapy and psychotherapy significantly contribute to reducing occupational dysfunction and enhancing quality of life. These findings underscore the need for tailored interventions that address the specific occupational challenges faced by individuals with MDD and AD, aiming for long-term functional recovery.

Heart failure (HF) is characterized by a progressive clinical course marked by frequent exacerbations and repeated hospitalizations, leading to considerably high morbidity and mortality rates. Patients with HF present with a constellation of bothersome symptoms, which range from physical to psychological and mental manifestations. With the transition to more advanced HF stages, symptoms become increasingly more debilitating, interfere with activities of daily living and disrupt multiple domains of life, including physical functioning, psychological status, emotional state, cognitive function, intimate relationships, lifestyle status, usual role activities, social contact and support. By inflicting profuse limitations in numerous aspects of life, HF exerts a profoundly negative impact on health-related quality of life (HRQOL). It is therefore not surprising that patients with HF display lower levels of HRQOL compared not only to the general healthy population but also to patients suffering from other chronic diseases. On top of this, poor HRQOL in patients with HF becomes an even greater concern considering that it has been associated with unfavorable long-term outcomes and poor prognosis. Nevertheless, HRQOL may differ significantly among patients with HF. Indeed, it has consistently been reported that women with HF display poorer HRQOL compared to men, while younger patients with HF tend to exhibit lower levels of HRQOL than their older counterparts. Moreover, patients presenting with higher New York Heart Association (NYHA) functional class (III–IV) have significantly more impaired HRQOL than those in a better NYHA class (I–II). Furthermore, most studies report worse levels of HRQOL in patients suffering from HF with preserved ejection fraction (HFpEF) compared to patients with HF with reduced ejection fraction (HFrEF) or HF with mildly reduced ejection fraction (HFmrEF). Last, but not least, differences in HRQOL have been noted depending on geographic location, with lower HRQOL levels having been recorded in Africa and Eastern Europe and higher in Western Europe in a recent large global study. Based on the observed disparities that have been invariably reported in the literature, this review article aims to provide insight into the underlying differences in HRQOL among patients with HF. Through an overview of currently existing evidence, fundamental differences in HRQOL among patients with HF are analyzed based on sex, age, NYHA functional class, ejection fraction and geographic location or ethnicity.