Emotional distress, positive affect, and mortality in patients with an implantable cardioverter defibrillator

K.C. van den Broek, F.B. Tekle, M. Habibovic, M. Alings, P.H. van der Voort, J. Denollet

Research output: Contribution to journalArticleScientificpeer-review

42 Citations (Scopus)
127 Downloads (Pure)


Little is known about the relationship between emotional distress and mortality in patients with an implantable cardioverter defibrillator (ICD). Our aim was to examine the predictive value of general negative and positive affect, and depressive symptoms (including its components somatic symptoms and cognitive-affective symptoms) for mortality.
ICD patients (N = 591, 81% male, mean age = 62.7 ± 10.1 years) completed the Global Mood Scale to measure the independent dimensions negative and positive mood, and the Beck Depression Inventory to measure depressive symptoms. Covariates consisted of demographic and clinical variables.
During the median follow-up of 3.2 years, 96 (16.2%) patients died. After controlling for covariates, negative affect was significantly related to all-cause mortality (HR = 1.034, p = 0.002), whereas positive affect was not (HR = 1.007, p = 0.61). Depressive symptoms were also independently associated with an increased mortality risk (HR = 1.031, p = 0.030) and somatic symptoms of depression in particular (HR = 1.130, p = 0.003), but cognitive-affective symptoms were not associated with mortality (HR = 0.968, p = 0.29). When entering both significant psychological predictors in a covariate-adjusted model, negative mood remained significant (HR = 1.039, p = 0.009), but somatic symptoms of depression did not (HR = 0.988, p = 0.78). Similar results were found for cardiac-related death. Of covariates, increased age, CRT, appropriate shocks were positively related to death.
Negative affect in general was related to mortality, but reduced positive affect was not. Depression, particularly its somatic symptoms, was also related to mortality, while cognitive-affective symptoms were not. Future research may further focus on the differential predictive value of emotional distress factors, as well as on mechanisms that relate emotional distress factors to mortality.
Keywords: Implantable cardioverter defibrillator, Mortality, Negative mood, Positive mood, Depression
Original languageEnglish
Pages (from-to)327-332
JournalInternational Journal of Cardiology
Issue number2
Publication statusPublished - 2013


Dive into the research topics of 'Emotional distress, positive affect, and mortality in patients with an implantable cardioverter defibrillator'. Together they form a unique fingerprint.

Cite this