Depression increases the risk of mortality in patients with heart failure: a meta-analysis.
Open accessAbstract
Background Depression is a risk factor for mortality in cardiovascular diseases. Prior studies confirm that depression predicts adverse outcomes in patients with heart failure (HF). However, data were inconclusive regarding the effect of depression on mortality. This meta-analysis examines the relationship between depression and mortality in HF.Methods Prospective studies of depression and mortality in HF published between 1999 and April 2016 were located using PubMed, PsychINFO, and MEDLINE. Comprehensive Meta-Analysis software was used to compute an aggregated effect size estimates of hazard ratios and to conduct subgroup analyses.Results Eighteen studies met inclusion criteria. For 8 aggregated univariate and 14 multivariate estimates, depressive symptoms were related to all-cause mortality. A pooled HR of 3 multivariate analyses indicated that depressive symptoms were not linked to cardiovascular mortality. In subgroup analyses, depression predicted all-cause mortality in samples with a mean age >65. The impact of depression on all-cause mortality also differed by follow-up duration, with samples with shorter follow-up durations demonstrating a larger effect.Conclusions In HF, depression is related to increased all-cause mortality risk, with stronger effects in samples with shorter follow-up and in older adults. In older adults, depression may serve as a marker of more severe HF. However, this possibility is difficult to examine given inconsistent adjustment for HF severity. Additional studies may assist in determining the relationship between depression and cardiovascular mortality, as the low number of studies examining cardiovascular mortality may have precluded detection of an effect.
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Psychiatric symptoms and illnesses are associated with worse outcomes regarding the CVD, including poorer prognosis, lower quality of life, increased risk of mortality, and interference with CVD treatment.
“Psychiatric symptoms and illnesses are in turn associated with several worse outcomes regarding the CVD: poorer prognosis of the course of the CVD, lower quality of life (QoL), increased risk of mortality, and interference with the CVD treatment, for example, due to worse adherence (3, 7–11).”
From Metacognitive Short-Term Intervention in Patients With Mental Disorders Following Cardiovascular Events (2022) · cites this paper as [8]
The Results (Effect of Depressive Symptoms; page unavailable) associate depressive symptoms with increased all-cause mortality in patients with heart failure, and the Depression in Heart Failure section describes more adverse clinical events. The paper does not establish the broader claim for psychiatric illnesses across CVD, nor does it substantiate lower quality of life or interference with treatment through poorer adherence. Its Results also find no significant association with cardiovascular-specific mortality. (LLM, conf=0.88)
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- Authors
- Gathright, E. C., Goldstein, C. M., Josephson, R. A., & Hughes, J. W.
- Affiliations
- Kent State University (US)
- Brown University (US)
- University Hospitals of Cleveland (US)
- Corresponding author
- Gathright, Emily C.
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2017-03
- Volume
- 94
- Pages
- 82-89
- ISSN
- 0022-3999 (ISSN-L)
- PMC
- PMC5370194
- OpenAlex
- W2579918759
- Cited by
- 156
- References
- 47
- Citations by year
- 2026: 12 · 2025: 14 · 2024: 19 · 2023: 17 · 2022: 16 · 2021: 21 · 2020: 22 · 2019: 17 · 2018: 11 · 2017: 7
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32HL076134)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- depression, heart failure, mortality, all-cause mortality, cardiovascular mortality, depressive symptoms, older adults, follow-up duration
- MeSH terms
- Depression, Heart Failure, Humans, Risk Factors
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