Depressed mood and subjective health symptoms as predictors of mortality in patients with congestive heart failure: a two-years follow-up study

Int J Psychiatry Med. 1999;29(3):311-26. doi: 10.2190/0C1C-A63U-V5XQ-1DAL.


Objective: The present study was undertaken in order to evaluate the relationship between depressed mood (depression, emotional distress) and disease-specific subjective health symptoms upon mortality risk among patients with congestive heart failure (CHF).

Methods and results: Proportional hazard models were used to evaluate the effects of selected biomedical, subjective health and psychological variables on mortality among 119 clinically stable patients (71.4% men; mean age 65.7 years +/- 9.6) with symptomatic heart failure, recruited from an outpatient cardiology practice. Twenty deaths were registered during the twenty-four-month period of data collection, all from cardiac causes. Results indicated that depressed mood was a significant predictor of mortality with a hazard ratio of 1.9, p .002. In contrast, subjective health was not a significant predictor of mortality in a Cox regression model that included depressed mood. The hazard ratio for a 1-point increase in Zung Depression Scale score was equal to 1.08 based on the multivariate model.

Conclusions: Results indicate that depressed mood is significantly related to increased mortality risk among heart failure patients. This finding is of concern to clinicians and should have implications for treatment of patients with congestive heart failure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anxiety Disorders / etiology
  • Anxiety Disorders / mortality
  • Depression / etiology
  • Depression / mortality*
  • Factor Analysis, Statistical
  • Female
  • Follow-Up Studies
  • Health Status*
  • Heart Failure / complications
  • Heart Failure / mortality*
  • Heart Failure / psychology*
  • Humans
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Prognosis
  • Proportional Hazards Models
  • Psychiatric Status Rating Scales / standards
  • Quality of Life*
  • Sampling Studies
  • Selection Bias
  • Severity of Illness Index
  • Survival Rate