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World J Psychiatry. Jun 19, 2026; 16(6): 116288 Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.116288
Redefining psychocardiology: Integrating depression management into heart failure care for enhanced long-term recovery and prognosis
Kai-Yuan Cen, Xiang-Long Liang, Ming-Liang Zhang
Kai-Yuan Cen, Xiang-Long Liang, Department of Cardiovascular Medicine, Guidong People’s Hospital of Guangxi Zhuang Autonomous Region, The Affiliated Guidong Hospital of Guilin Medical University, Wuzhou 543000, Guangxi Zhuang Autonomous Region, China
Ming-Liang Zhang, Department of Cardiovascular Medicine, Heilongjiang Provincial Hospital, Harbin 150036, Heilongjiang Province, China
Co-first authors: Kai-Yuan Cen and Xiang-Long Liang.
Author contributions: Cen KY and Liang XL drafted the manuscript, and they contributed equally to this manuscript as co-first authors; Cen KY and Zhang ML critically revised the manuscript for important intellectual content and provided supervision. All authors have read and approved the final version of the manuscript.
AI contribution statement: The authors confirm that ChatGPT was used only to improve the language, grammar, clarity, and readability of the manuscript. The authors carefully reviewed, revised, and approved all AI-assisted language edits and take full responsibility for the accuracy, originality, and integrity of the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Received: November 10, 2025 Revised: November 26, 2025 Accepted: January 4, 2026 Published online: June 19, 2026 Processing time: 201 Days and 22.7 Hours
Abstract
Depression is a highly prevalent and often under-recognized comorbidity in heart failure (HF), contributing to worse symptoms, impaired self-care, increased rehospitalization risk, and reduced quality of life. Nowadays, some studies link depression severity with poorer ventricular function, lower medication adherence, and increased readmission rates. This suggests that depression management should be treated as a core component of HF care rather than an optional add-on. In this paper, we briefly summarize the bidirectional links between HF and depression and highlight that, although depression strongly predicts adverse outcomes, large randomized trials of antidepressants and collaborative care have not been shown to reduce HF hospitalizations or mortality. These sobering data call for a cautious approach, reframing depression as a risk marker rather than a risk factor. We then outline a pragmatic psychocardiology agenda: Routine screening; stepped collaborative care embedded in HF services; and judicious use of digital tools to support—not replace—human care. Rather than promising a new cure, we propose a realistic redefinition of psychocardiology that focuses on protecting patients from the clinical consequences of untreated depression while acknowledging the current limits of evidence for hard cardiovascular endpoints.
Core Tip: Depression is common in heart failure (HF) and reliably identifies patients at higher risk of poor self-care, rehospitalization, and death, yet treating depression has not consistently improved hard HF outcomes. Using new data from a retrospective cohort study, this review calls for a pragmatic form of “psychocardiology”: Routinely screening for depression; embedding simple collaborative-care models into HF services; and using digital tools cautiously as supports rather than standalone solutions. The goal is not to promise fewer HF events, but to reduce the avoidable suffering associated with living with both HF and depression.
