Current Heart Failure Reports

, Volume 10, Issue 3, pp 244–253 | Cite as

How are Depression and Type D Personality Associated with Outcomes in Chronic Heart Failure Patients?

  • Jos WiddershovenEmail author
  • Dionne Kessing
  • Angélique Schiffer
  • Johan Denollet
  • Nina Kupper
Self-Care and Health Outcomes (T Jaarsma, Section Editor)


This review aims to summarize the current evidence for the association of depression and Type D personality with clinical and patient-centred outcomes and self-care in chronic heart failure (CHF) patients. Emotional distress is highly prevalent in CHF patients. In contrast to results in coronary artery disease, there is inconsistent evidence for the adverse effects of depression and Type D on prognosis. Type D and depression are important predictors of impaired health status in CHF, and patients characterised by depression or Type D report reduced self-care. Pathophysiological processes associated with depression and Type D are discussed, as they may contribute to disease progression. Future research may benefit from taking inconsistencies in and problems with assessment of depression and Type D into account, as well as focusing on the network of psychophysiological and behavioural factors to elucidate their precise role in CHF patients with depression or Type D. Furthermore, it is advised that clinicians address the observed differences in self-care behaviours to improve health in CHF patients with depression or Type D personality.


Depression Type D personality Chronic heart failure Medical outcomes Patient reported outcomes Behavioural Biological Mechanisms Mortality Review Emotional distress Health status Self-care Psychobiological 


Compliance with Ethics Guidelines

Conflict of Interest

Jos Widdershoven is supported by grants from Medtronic, St. Jude Medical, Inc., Boston Scientific, and Sorin, and has been reimbursed for travel/accommodations/meeting expenses for a congressional travel grant.

Dionne Kessing declares that she has no conflict of interest.

Angélique Schiffer declares that she has no conflict of interest.

Johan Denollet declares that he has no conflict of interest.

Nina Kupper is supported by a grant from the Netherlands Organization for Scientific Research (NWO), and has received payment for lectures for the RINO group, an institution for postdoctoral education.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Jos Widdershoven
    • 1
    • 2
    Email author
  • Dionne Kessing
    • 1
  • Angélique Schiffer
    • 3
  • Johan Denollet
    • 1
  • Nina Kupper
    • 1
  1. 1.CoRPS – Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical PsychologyTilburg UniversityTilburgThe Netherlands
  2. 2.Department of CardiologyTweeSteden HospitalTilburg/Waalwijkthe Netherlands
  3. 3.Department of Medical PsychologyTweeSteden HospitalTilburg/Waalwijkthe Netherlands

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