Precipitation of Congestive Heart Failure: Social and Emotional Factors

Because of discrepancies in the literature and common lack of knowledge about the role of emotions in the precipitation of congestive heart failure, a group of 105 patients with congestive heart failure and a comparison group of 50 patients were studied. Emotional factors antedated hospitalization in 49% (51 of 105) of the group with congestive failure and 24% (12 of 50) of the other group (P < 0.01). Congestive-failure patients also had difficulty accepting their illness, and overt denial was observed in eight patients as compared to none of the comparison group. Patients' attitudes toward their living arrangements correlated with the presence of a preceding emotional event. When a patient lived with close relatives, emotional events were commoner than when interpersonal relationships were at a formal level (nursing home or domiciliary facility). Patients most satisfied with living conditions had less preceding emotional upsets.