The co-occurence of depression and congestive heart failure (CHF) represents a great challenge and opportunity for those interested in exploring the complex interactions between the brain and the heart. The cumulative effect of these medical conditions has an evident effect on quality of life.

The objective of this study was to evaluate the quality of life and symptoms of depression among a group of 103 adult patients with CHF recruited from an outpatient cardiology practice and determine the factors related to a poor outcome. The challenge was to identify the group of patients who are at risk of suffering from depression and poor quality of life as early as possible and try to provide them appropriate psychiatric treatment.

The results of this study lead us to suggest that an older female patient with a more severe illness (NYHA ≥ II) and renal impairment is at great risk of presenting simultaneously depressive sintomatology and poorer perception of quality of life, thus beeing a strong candidate to a very negative evolution of her cardiac condition.

These findings allow us to define a group of patients that would surely benefit from a closer psychiatric and cardiac management.

The high prevalence of depression, the complexity of managing it and the recent evidence demonstrating that depression is associated with increased morbidity and mortality suggests that is important the development of collaborative and integrative approaches combining the medical expertise and interest of psychiatrists, cardiologists and internists and the involvement of psychologists and social workers.