Depression and heart failure: decline in quality of life and future management considerations.

This article is focused on the research studies assessing the effects of depression as the mental disorder on the treatment and the prognosis of heart failure (HF). The association between HF and depression seems to be related to the psychological aspects of severe heart disease and to pathophysiological and psychosocial mechanisms. Depression may be a risk factor for the development of HF and conversely, chronic illnesses such as HF may precipitate depression. Furthermore depression symptoms are reported to be the strongest predictor of decline in health status, increased morbidity and hospital readmissions or even mortality in HF patients. Different treatment modalities include pharmacologic therapy, psychotherapy (e.g. supportive, cognitive behavioral, interpersonal, psychodynamic and group therapies) and when necessary, psychiatric hospitalization. Detection and treatment of depression should be a part of the comprehensive approach to HF patients by cardiologists and family physicians. The development of effective therapeutic interventions both for modifying high-risk lifestyles and behavior and for reducing psychosocial risk factors for HF patients remains a challenge. Recognition and successful treatment of depression might improve relevant clinical outcomes among patients with chronic HF and may be an important component of HF care and significantly improve quality of life.