Psychological Distress and Mortality in Systolic Heart Failure
Open accessAbstract
Background— Depression, anxiety, and type D (“distressed”) personality (tendency to experience negative emotions paired with social inhibition) have been associated with poor prognosis in coronary heart disease, but little is known about their role in chronic heart failure. Therefore, we investigated whether these indicators of psychological distress are associated with mortality in chronic heart failure. Method and Results— Consecutive outpatients with chronic heart failure (n=641; 74.3% men; mean age, 66.6±10.0 years) filled out a 4-item questionnaire to assess mixed symptoms of anxiety and depression and the 14-item type D scale. End points were defined as all-cause and cardiac mortality. After a mean follow-up of 37.6±15.6 months, 123 deaths (76 due to cardiac cause) were recorded. Cumulative hazard functions for elevated anxiety/depression symptoms differed marginally for all-cause ( P =0.06), but not cardiac, mortality ( P =0.43); type D personality was associated with neither all-cause mortality ( P =0.63) nor cardiac mortality ( P =0.87). In multivariable analyses, neither elevated anxiety/depression symptoms nor type D personality was associated with all-cause mortality (hazard ratio [HR]=1.18; 95% CI, 0.76 to 1.84; P =0.45 and HR=1.09; 95% CI, 0.67 to 1.77; P =0.73, respectively) or cardiac mortality (HR=1.13; 95% CI, 0.63 to 2.04; P =0.65 and HR=1.16; 95% CI, 0.62 to 2.18; P =0.67). In secondary analyses, a 1-point increase in anxiety/depression (range, 0 to 16) was associated with an 8% increase in risk for all-cause mortality (HR=1.08; 95% CI, 1.01 to 1.15; P =0.02). Conclusions— Neither elevated anxiety/depression symptoms nor type D personality was associated with an increased risk for all-cause or cardiac mortality. Future studies with adequate power and a longer follow-up duration are needed to further elucidate the role of psychological distress in chronic heart failure.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Negative findings have been reported for all-cause and cardiovascular mortality over 3 years in CVD patients for Type D.
“However, negative findings have been reported for all-cause and cardiovascular mortality over 3 years in CVD patients [144]”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [144]
These latter two studies reported small to modest elevations in mortality risk for Type D that were not statistically significant.
“These latter two studies reported small to modest elevations in mortality risk for Type D that were not statistically significant.”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [144]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005)
Swedberg, K. B., Cleland, J. G. F., Dargie, H., Drexler, H., Folláth, F., Michel Komajda, N., Tavazzi, L., Smiseth, O. A., Gavazzi, A., Haverich, A., et al. (2005) · European Heart Journal · doi:10.1093/eurheartj/ehi204 · Cited by 2,243 · see citing works
Long-term trends in the incidence of and survival with heart failure
Levy, D., Kenchaiah, S., Larson, M. G., Benjamin, E. J., Kupka, M. J., Ho, K. K. L., Murabito, J. M., & Vasan, R. S. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa020265 · Cited by 2,152 · see citing works
DS14: Standard Assessment of Negative Affectivity, Social Inhibition, and Type D Personality
Denollet, J. (2005) · Psychosomatic Medicine · doi:10.1097/01.psy.0000149256.81953.49 · Cited by 1,556 · see citing works
Self-citationMcMurray, J. J. V., & Pfeffer, M. A. (2005) · The Lancet · doi:10.1016/s0140-6736(05)66621-4 · Cited by 834 · see citing works
Frasure-Smith, N., & Lespérance, F. (2008) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2007.4 · Cited by 571 · see citing works
Evidence of Improving Prognosis in Heart Failure
Macintyre, K., Capewell, S., Stewart, S., Chalmers, J. W. T., Boyd, J., Finlayson, A. R., Redpath, A., Pell, J. P., & McMurray, J. J. V. (2000) · Circulation · doi:10.1161/01.cir.102.10.1126 · Cited by 553 · see citing works
Health Status Predicts Long-Term Outcome in Outpatients With Coronary Disease
Spertus, J., Jones, P. G., McDonell, M., Fan, V., & Fihn, S. (2002) · Circulation · doi:10.1161/01.cir.0000020688.24874.90 · Cited by 528 · see citing works
Denollet, J., & Brutsaert, D. L. (1998) · Circulation · doi:10.1161/01.cir.97.2.167 · Cited by 400 · see citing works
Self-citationHeart failure and the aging population: an increasing burden in the 21st century?
Stewart, S., MacIntyre, K., Capewell, S., & McMurray, J. J. V. (2002) · Heart · doi:10.1136/heart.89.1.49 · Cited by 388 · see citing works
Inadequate Response to Treatment in Coronary Heart Disease
Denollet, J., Vaes, J., & Brutsaert, D. L. (2000) · Circulation · doi:10.1161/01.cir.102.6.630 · Cited by 388 · see citing works
Self-citationKonstam, V., Salem, D. N., Pouleur, H. G., Kostis, J. B., Gorkin, L., Shumaker, S. A., Mottard, I., Woods, P., Konstam, M. A., & Yusuf, S. (1996) · The American Journal of Cardiology · doi:10.1016/s0002-9149(96)00463-8 · Cited by 354 · see citing works
Relationship of Depression to Death or Hospitalization in Patients With Heart Failure
Sherwood, A. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.4.367 · Cited by 342 · see citing works
Incidence and Prevalence of Heart Failure in Elderly Persons, 1994-2003
Curtis, L. H. (2008) · Archives of Internal Medicine · doi:10.1001/archinternmed.2007.80 · Cited by 334 · see citing works
Friedmann, E., Thomas, S. A., Liu, F., Morton, P. G., Chapa, D., & Gottlieb, S. S. (2006) · American Heart Journal · doi:10.1016/j.ahj.2006.05.009 · Cited by 309 · see citing works
Prognostic Value of Anxiety and Depression in Patients With Chronic Heart Failure
Jiang, W., Kuchibhatla, M. N., Cuffe, M. S., Christopher, E. J., Alexander, J. D., Clary, G. L., Blazing, M. A., Gaulden, L. H., Califf, R. M., Krishnan, R. R., et al. (2004) · Circulation · doi:10.1161/01.cir.0000148138.25157.f9 · Cited by 264 · see citing works
Psychological Factors in Heart Failure
Macmahon, K., & Lip, G. Y. H. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.5.509 · Cited by 255 · see citing works
Chronic and Acute Psychological Risk Factors for Clinical Manifestations of Coronary Artery Disease
Kop, W. J. (1999) · Psychosomatic Medicine · doi:10.1097/00006842-199907000-00012 · Cited by 239 · see citing works
Frasure‐Smith, N., Lespérance, F., Habra, M. E., Talajic, M. R., Khairy, P., Dorian, P., & Roy, D. (2009) · Circulation · doi:10.1161/circulationaha.109.851675 · Cited by 232 · see citing works
Vázquez, R., Bayés‐Genís, A., Cygankiewicz, I., Pascual-Figal, D. A., Grigorian-Shamagian, L., Pavón, R., González‐Juanatey, J. R., Cubero, J. M., Pastor, L., Ordóñez‐Llanos, J., et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp032 · Cited by 224 · see citing works
Depression Increasingly Predicts Mortality in the Course of Congestive Heart Failure
Jünger, J., Schellberg, D., Müller‐Tasch, T., Raupp, G., Zugck, C., Haunstetter, A., Zipfel, S., Herzog, W., & Haass, M. (2004) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2004.05.011 · Cited by 217 · see citing works
Murberg, T. A., Bru, E., Svebak, S., Tveterås, R., & Aarsland, T. (1999) · The International Journal of Psychiatry in Medicine · doi:10.2190/0c1c-a63u-v5xq-1dal · Cited by 198 · see citing works
Evolving Applications for Patient-Centered Health Status Measures
Spertus, J. A. (2008) · Circulation · doi:10.1161/circulationaha.107.747568 · Cited by 172 · see citing works
Type D personality: the heart, stress, and cortisol
Sher, L. (2005) · QJM · doi:10.1093/qjmed/hci064 · Cited by 167 · see citing works
Denollet, J., Pedersen, S. S., Ong, A. T. L., Erdman, R. A. M., Serruys, P. W. J. C., & van Domburg, R. T. (2005) · European Heart Journal · doi:10.1093/eurheartj/ehi616 · Cited by 165 · see citing works
Self-citationA longitudinal analysis of anxiety and depressive symptoms.
Wetherell, J. L., Gatz, M., & Pedersen, N. L. (2001) · Psychology and Aging · doi:10.1037/0882-7974.16.2.187 · Cited by 161 · see citing works
Krumholz, H. M., Peterson, E. D., Ayanian, J. Z., Chin, M. H., DeBusk, R. F., Goldman, L., Kiefe, C. I., Powe, N. R., Rumsfeld, J. S., Spertus, J. A., et al. (2005) · Circulation · doi:10.1161/circulationaha.105.536102 · Cited by 159 · see citing works
Bankier, B., Januzzi, J. L., & Littman, A. B. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000138126.90551.62 · Cited by 146 · see citing works
Pedersen, S. S., Lemos, P. A., van Vooren, P. R., Liu, T. K. K., Daemen, J., Erdman, R. A. M., Smits, P. C., Serruys, P. W. J. C., & van Domburg, R. T. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.05.064 · Cited by 145 · see citing works
Self-citationSchiffer, A. A., Pedersen, S. S., Widdershoven, J. W. M. G., Hendriks, E. H., Winter, J. B., & Denollet, J. (2005) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/01.hjr.0000173107.76109.6c · Cited by 134 · see citing works
Self-citationType-D personality is a stable taxonomy in post-MI patients over an 18-month period
Martens, E. J., Kupper, N. H. M., Pedersen, S. S., Aquarius, A. E., & Denollet, J. (2007) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2007.06.005 · Cited by 124 · see citing works
Self-citationPsychological Predictors of Prognosis in Chronic Heart Failure
Pelle, A. J. M., Gidron, Y., Szabó, B. M., & Denollet, J. (2008) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2008.01.004 · Cited by 107 · see citing works
Self-citationAl‐Ruzzeh, S., Athanasiou, T., Mangoush, O., Wray, J., Modine, T., George, S., & Amrani, M. (2005) · Heart · doi:10.1136/hrt.2004.047068 · Cited by 102 · see citing works
Passantino, A., Lagioia, R., Mastropasqua, F., & Scrutinio, D. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.02.061 · Cited by 98 · see citing works
Denollet, J., Strik, J., Lousberg, R., & Honig, A. (2006) · Psychotherapy and Psychosomatics · doi:10.1159/000095440 · Cited by 94 · see citing works
Self-citationAn epidemic of heart failure? Recent evidence from Europe.
Hoes, A. W., Mosterd, A., & Grobbee, D. E. (1998) · PubMed · Cited by 89 · see citing works
Long-term Survival in Elderly Patients Hospitalized for Heart Failure
Huynh, B., Rovner, A., & Rich, M. W. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.17.1892 · Cited by 88 · see citing works
Type D personality and cardiac mortality in patients with chronic heart failure
Schiffer, A. A., Smith, O. R. F., Pedersen, S. S., Widdershoven, J. W., & Denollet, J. (2010) · International Journal of Cardiology · doi:10.1016/j.ijcard.2008.12.090 · Cited by 83 · see citing works
Self-citationDepression and Survival in Chronic Heart Failure: Does Gender Play a Role?
Faller, H., Störk, S., Schowalter, M., Steinbüchel, T., Wollner, V., Ertl, G., & Angermann, C. E. (2007) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2007.06.011 · Cited by 82 · see citing works
de Jonge, P., Denollet, J., van Melle, J. P., Kuyper, A. M. G., Honig, A., Schene, A. H., & Ormel, J. (2007) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2007.06.002 · Cited by 77 · see citing works
Self-citationMurberg, T. A., & Furze, G. (2004) · PubMed · Cited by 67 · see citing works
Schiffer, A. A., Pedersen, S. S., Widdershoven, J. W. M. G., & Denollet, J. (2008) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2008.06.012 · Cited by 63 · see citing works
Self-citationPrognostic Value of Type D Personality Compared With Depressive Symptoms
Denollet, J. (2008) · Archives of Internal Medicine · doi:10.1001/archinternmed.2007.120 · Cited by 57 · see citing works
Self-citationSchiffer, A. A., Pedersen, S. S., BROERS, H., Widdershoven, J. W. M. G., & Denollet, J. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.05.021 · Cited by 57 · see citing works
Self-citationUnfavorable Outcome of Heart Transplantation in Recipients With Type D Personality
Denollet, J., Holmes, R. V. F., Vrints, C. J., & Conraads, V. M. (2007) · The Journal of Heart and Lung Transplantation · doi:10.1016/j.healun.2006.11.600 · Cited by 57 · see citing works
Self-citationAbhayaratna, W. P., Marwick, T. H., Becker, N. G., Jeffery, I., McGill, D. A., & Smith, W. T. (2006) · American Heart Journal · doi:10.1016/j.ahj.2006.05.007 · Cited by 55 · see citing works
Pelle, A. J. M., Erdman, R. A. M., van Domburg, R. T., Spiering, M., Kazemier, M., & Pedersen, S. S. (2008) · Annals of Behavioral Medicine · doi:10.1007/s12160-008-9057-4 · Cited by 51 · see citing works
Self-citationSpindler, H., Pedersen, S. S., Serruys, P. W. J. C., Erdman, R. A. M., & van Domburg, R. T. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.09.009 · Cited by 47 · see citing works
Self-citationImpact of depression on quality of life assessment in heart failure
Faller, H., Steinbüchel, T., Störk, S., Schowalter, M., Ertl, G., & Angermann, C. E. (2009) · International Journal of Cardiology · doi:10.1016/j.ijcard.2008.12.093 · Cited by 42 · see citing works
Subramanian, U., Eckert, G. J., Yeung, A., & Tierney, W. M. (2007) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2006.11.007 · Cited by 32 · see citing works
Schiffer, A. A., Pedersen, S. S., Widdershoven, J. W. M. G., & Denollet, J. (2008) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2008.07.010 · Cited by 30 · see citing works
Self-citationSmith, O. R. F., Pedersen, S. S., van Domburg, R. T., & Denollet, J. (2008) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/hjr.0b013e3283083e17 · Cited by 26 · see citing works
Self-citationAkazawa, K., Nakamura, T., Moriguchi, S., Shimada, M., & Nose, Y. (1991) · Computer Methods and Programs in Biomedicine · doi:10.1016/0169-2607(91)90122-a · Cited by 20 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Depression and anxiety in heart failure: a review.
Celano, C. M., Villegas, A. C., Albanese, A. M., Gaggin, H. K., & Huffman, J. C. (2018) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000162 · Cited by 610 · see citing works
Denollet, J., Schiffer, A. A., & Spek, V. (2010) · Circulation: Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.109.934406 · Cited by 282 · see citing works
Self-citationChapman, B. P., Roberts, B., & Duberstein, P. (2011) · Journal of Aging Research · doi:10.4061/2011/759170 · Cited by 283 · see citing works
“However, negative findings have been reported for all-cause and cardiovascular mortality over 3 years in CVD patients [144], and for 7-year all-cause mortality in patients with chronic obstructive pulmonary disease (COPD) [145].”
BackgroundPathophysiological relationships between heart failure and depression and anxiety
Chapa, D. W., Akintade, B., Son, H., Woltz, P., Hunt, D., Friedmann, E., Hartung, M. K., & Thomas, S. A. (2014) · Critical Care Nurse · doi:10.4037/ccn2014938 · Cited by 47 · see citing works
- Authors
- Pelle, A. J., Pedersen, S. S., Schiffer, A. A., Szabó, B., Widdershoven, J. W., & Denollet, J.
- Affiliations
- Tilburg University (NL)
- From the CoRPS–Center of Research on Psychology in Somatic diseases (A.J.P., S.S.P., J.D.), Tilburg University, Tilburg, The Netherlands; Department of Medical Psychology (A.A.S.), Tweesteden Hospital, Tilburg, The Netherlands; Department of Cardiology (B.S.), St Elisabeth Hospital, Tilburg, The Netherlands; and Department of Cardiology (J.W.W.), Tweesteden Hospital, Tilburg, The Netherlands.
- Venue
- Circulation: Heart Failure
- Published
- 2010-03
- Volume
- 3
- Issue
- 2
- Pages
- 261-267
- ISSN
- 1941-3289 (ISSN-L)
- 1941-3297
- OpenAlex
- W2112090492
- Cited by
- 89
- References
- 52
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 2 · 2020: 5 · 2019: 5 · 2018: 1 · 2017: 5 · 2016: 10 · 2015: 9 · 2014: 4 · 2013: 14 · 2012: 11
- FWCI
- 7.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Research portal (Tilburg University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- 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
- psychological distress, chronic heart failure, heart failure with reduced ejection fraction, depression, anxiety, Type D personality, all-cause mortality, cardiac mortality, prognosis, social inhibition, negative emotions
- MeSH terms
- Aged, Anxiety, Cause of Death, Depression, Female, Humans, Male, Netherlands, Personality, Prognosis, Surveys and Questionnaires, Risk Factors, Prevalence, Chi-Square Distribution, Logistic Models, Proportional Hazards Models, Heart Failure, Systolic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
