Psychological Predictors of Prognosis in Chronic Heart Failure

Aline J.M. Pelle, Yori Y. Gidron, Balázs M. Szabó, Johan Denollet

Research output: Contribution to journalReview articlepeer-review


Background: Chronic heart failure (CHF) is an increasingly prevalent condition with high mortality and morbidity rates. This review examines the role of depression, anxiety, and social support on prognosis in CHF. Method and Results: Prospective studies that examined mortality as an outcome, and assessed depression, anxiety, or social support as associates were included. Methodological qualities were evaluated. In total, 25 studies were identified. Concerning depression, 6 of 15 studies of inpatients, 10 of 11 studies of outpatients, and 1 study of a mixed sample found associations between depression and prognosis, with greater associations rendered by depressive symptomatology in outpatients. Anxiety was not associated with prognosis in one inpatient study and one outpatient study. There was a univariable trend in one outpatient study for anxiety to be associated with prognosis. In two of six studies of inpatients and in two of four studies of outpatients, social support was associated with prognosis. On the basis of methodological quality, studies on depression showed mixed results, no conclusions could be drawn for anxiety because this association was not investigated soundly, and the quality of the social network was not associated with outcome. Conclusion: Evidence suggests that depressive symptoms and social support might be associated with prognosis in CHF outpatients, independently of biomedical risk factors. With respect to anxiety, no conclusions can be drawn. Future studies are warranted to disentangle associations with psychological factors.

Original languageEnglish
Pages (from-to)341-350
Number of pages10
JournalJournal of Cardiac Failure
Issue number4
StatePublished - May 2008
Externally publishedYes

Bibliographical note

Funding Information:
No conflicts of interest are reported. The present study was supported by a VICI-grant (453-04-004) from the Netherlands Organization for Scientific Research, The Hague, The Netherlands, to Dr. Johan Denollet.


  • Anxiety
  • chronic heart failure
  • depression
  • social support

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Psychological Predictors of Prognosis in Chronic Heart Failure'. Together they form a unique fingerprint.

Cite this