Pelle Aline J M, Gidron Yori Y, Szabó Balázs M, Denollet Johan
CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical Psychology, Tilburg University, The Netherlands.
J Card Fail. 2008 May;14(4):341-50. doi: 10.1016/j.cardfail.2008.01.004.
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.
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.
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.
慢性心力衰竭（CHF）是一种日益普遍的疾病，死亡率和发病率都很高。本综述探讨了抑郁、焦虑和社会支持在CHF预后中的作用。
纳入以死亡率为结局，并将抑郁、焦虑或社会支持作为相关因素进行评估的前瞻性研究。对研究方法的质量进行了评估。共确定了25项研究。关于抑郁，15项住院患者研究中的6项、11项门诊患者研究中的10项以及1项混合样本研究发现抑郁与预后之间存在关联，门诊患者的抑郁症状与预后的关联更强。在一项住院患者研究和一项门诊患者研究中，焦虑与预后无关。在一项门诊患者研究中，焦虑与预后存在单变量趋势。在6项住院患者研究中的2项以及4项门诊患者研究中的2项中，社会支持与预后相关。基于研究方法的质量，关于抑郁的研究结果不一，由于对焦虑与预后的关联研究不够充分，无法得出结论，并且社会网络质量与结局无关。
有证据表明，抑郁症状和社会支持可能与CHF门诊患者的预后相关，独立于生物医学风险因素。关于焦虑，无法得出结论。未来的研究有必要厘清与心理因素的关联。
