生命意义丧失可能是顽固性心力衰竭伴抑郁的启动因素之一

doi:10.3969/j.issn.1004-583X.2026.10.011

摘要/Abstract

摘要：

顽固性心力衰竭患者抑郁发病率明显高于普通人群,且往往病情更重,预后不佳。生命意义的丧失可能是其抑郁发生和加重的原因之一。结合心理医学诊疗进展,本文提出可能的解决方案。通过构建心血管专业医师与心理医师的合作机制,同步进行心力衰竭治疗及心理治疗,进而改善顽固性心力衰竭伴抑郁的产生和发展。

关键词: 心力衰竭, 抑郁, 生命意义丧失

Abstract:

The incidence of depression in patients with refractory heart failure is significantly higher than that in the general population, and these patients often have more severe disease and poorer outcomes. Loss of meaning in life may be one of the causes of the onset and worsening of depression. Building on recent advances in psychiatric diagnosis and treatment, this article proposes possible solutions. By establishing a collaborative mechanism between cardiovascular specialists and psychiatrists, patients can receive simultaneous treatment for heart failure and psychological therapy, thereby improving the development and progression of depression in refractory heart failure.

Key words: heart failure, depression, loss of meaning in life

中图分类号:

R541.6

马业宁, 李棣, 李逸霄, 王汉林, 张晶. 生命意义丧失可能是顽固性心力衰竭伴抑郁的启动因素之一[J]. 临床荟萃, 2026, 41(10): 938-942.

Ma Yening, Li Di, Li Yixiao, Wang Hanlin, Zhang Jing. Loss of meaning in life may be one of the initiating factors for depression in patients with refractory heart failure[J]. Clinical Focus, 2026, 41(10): 938-942.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.10.011

https://www.lchc.cn/CN/Y2026/V41/I10/938

参考文献 42

[1]	Bueno H, Deaton C, Farrero M, et al. 2025 ESC Clinical Consensus Statement on mental health and cardiovascular disease: Developed under the auspices of the ESC Clinical Practice Guidelines Committee[J]. Eur Heart J, 2025, 46(41):4156-4225. doi:10.1093/eurheartj/ehaf191.
[2]	Xing F, Gao M, Wu Y, et al. Influence of depression trajectories in heart failure patients with preserved ejection fractions: A secondary analysis of adverse outcomes in the TOPCAT trial[J]. Heart, 2025, 111(15): 733-740. doi: 10.1136/heartjnl-2024-324505. pmid: 40089312
[3]	Celano CM, Huffman JC, Beale AL, et al. Appreciating the links between heart failure and depression[J]. QJM, 2024, 117(1): 3-10. doi: 10.1093/qjmed/hcad213.
[4]	Crump C, Sundquist J, Kendler KS, et al. Psychiatric disorders and mortality in heart failure: A Swedish nationwide cohort study[J]. JACC Heart Fail, 2026, 14(9): 103098. doi: 10.1016/j.jchf.2026.103098.
[5]	中华医学会心血管病学分会, 中国医师协会心血管内科医师分会, 中国医师协会心力衰竭专业委员会, 等. 中国心力衰竭诊断和治疗指南2024[J]. 中华心血管病杂志, 2024, 52(3):235-275.doi:10.3760/cma.j.cn112148-20231101-00405.
[6]	Zuccarella-Hackl C, Princip M, Sivakumar S, et al. Positive psychological well-being and cardiovascular health[J]. Front Psychiatry, 2024, 15: 1443978. doi: 10.3389/fpsyt.2024.1443978.
[7]	Sutin AR, Luchetti M, Stephan Y, et al. Purpose in life and C-reactive protein: An individual-participant meta-analysis of >50, 000 adults[J]. Psychoneuroendocrino, 2025, 181: 107614. doi: 10.1016/j.psyneuen.2025.107614.
[8]	Kleman C, Turrise S, Winslow H, et al. Individual and systems-related factors associated with heart failure self-care: A systematic review[J]. BMC Nurs, 2024, 23: 110. doi: 10.1186/s12912-023-01689-9. pmid: 38336711
[9]	Carmin CN, Ownby RL, Fontanella C, et al. Impact of mental health treatment on outcomes in patients with heart failure and ischemic heart disease[J]. J Am Heart Assoc, 2024, 13(7): e031117. doi: 10.1161/JAHA.123.031117.
[10]	Freedland KE, Skala JA, Carney RM, et al. Psychosocial syndemics and multimorbidity in patients with heart failure[J]. J Psychiatr Brain Sci, 2021, 6:e210006. doi:10.20900/jpbs.20210006.
[11]	Ouyang WH, Wang XQ, Cai JY, et al. A three-level meta-analysis of the relationship between meaning in life and depression[J]. J Affect Disord, 2026, 398: 121045. doi: 10.1016/j.jad.2025.121045.
[12]	Sutin AR, Luchetti M, Stephan Y, et al. Purpose in life and depressive symptoms: An individual-participant meta-analysis of >500, 000 participants across six world regions[J]. J Affect Disord, 2026, 398: 120881. doi: 10.1016/j.jad.2025.120881.
[13]	刘薇, 高敏, 仲伟楠, 等. 慢性心力衰竭患者生命意义感现状及影响因素分析[J]. 实用临床医药杂志, 2023, 27(3): 40-45. doi: 10.7619/jcmp.20221549.
[14]	Tam KW, Zhang D, Li Y, et al. Meaning in life: Bidirectional relationship with depression, anxiety, and loneliness in a longitudinal cohort of older primary care patients with multimorbidity[J]. BMC Geriatr, 2025, 25: 195. doi: 10.1186/s12877-025-05762-7. pmid: 40128661
[15]	Westas M, Melnikov S. Prevalence and outcomes of fears in advanced heart failure: Differences across disease stages[J]. Curr Heart Fail Rep, 2025, 22: 18. doi: 10.1007/s11897-025-00705-0. pmid: 40381090
[16]	Rashid A, Moser DK, et al. Heart failure beyond the diagnosis: A narrative review of patients' perspectives on daily life and challenges[J]. J Am Heart Assoc, 2025, 14(11): e031245. doi: 10.1161/JAHA.124.031245.
[17]	Seckin M, Stewart S, Johnston B. Symptoms matter-symptom diversity and trajectory across different phases of heart failure: From diagnosis to end of life[J]. Curr Opin Support Palliat Care, 2025, 19(4): 234-241. doi: 10.1097/SPC.0000000000000774.
[18]	熊英, 付蓉, 胡经文, 等. 患者视角下心力衰竭终末期真实体验和需求的研究[J]. 中国医学伦理学, 2025, 38(11): 1453-1459. doi: 10.12026/j.issn.1001-8565.2025.11.11.
[19]	马丹妮, 唐佳敏, 丁一祺, 等. 慢性心力衰竭患者习得性无助现状及影响因素的混合研究[J]. 中华护理杂志, 2026, 61(14): 1894-1902. doi: 10.3761/j.issn.0254-1769.2026.14.003.
[20]	Volterrani M, Halasz G, Adamopoulos S, et al. Quality of life in heart failure. The heart of the matter. A scientific statement of the Heart Failure Association and the European Association of Preventive Cardiology of the European Society of Cardiology[J]. Eur J Heart Fail, 2025, 27(7): 1159-1173. doi: 10.1002/ejhf.3440. pmid: 40070300
[21]	Huang Z, Chair SY. Disease severity, illness perceptions, depression and health-related quality of life in patients with heart failure[J]. J Clin Nurs, 2025, 34(10): 4293-4300. doi: 10.1111/jocn.17653.
[22]	Huang Z, Liu T, Cao X, et al. Illness perceptions and self-care behaviors among Chinese hospitalized adults with heart failure[J]. BMC Psychol, 2025, 13: 1335. doi: 10.1186/s40359-025-03693-x.
[23]	Nam Y, Sethares KA. Heart failure self-care and spirituality: An integrative review[J]. J Cardiovasc Nurs, 2026, 41(5): E426-E435. doi: 10.1097/JCN.0000000000001310.
[24]	Leung J, Li KK. Spiritual connectivity intervention for individuals with depressive symptoms: A randomized control trial[J]. Healthcare, 2024, 12(16): 1604. doi: 10.3390/healthcare12161604.
[25]	Zhang G, Zhang Q, Li F, et al. The impact of spiritual care on the psychological health and quality of life of adults with heart failure: A systematic review of randomized trials[J]. Front Med, 2024, 11: 1334920. doi: 10.3389/fmed.2024.1334920.
[26]	Sutin AR, Luchetti M, Karakose S, et al. Meaning in life and all-cause and cause-specific mortality in the UK Biobank[J]. J Psychosom Res, 2025, 188: 111971. doi: 10.1016/j.jpsychores.2024.111971.
[27]	Bell MJ, Ferraro KF. Volunteering and risk of heart attack in later life: The moderating role of purpose in life?[J]. Res Aging, 2025, 47(2): 140-150. doi: 10.1177/01640275241274316.
[28]	Meraz R, Elkins G, McGee JS, et al. Posttraumatic growth theory as a framework for heart failure self-care intervention design[J]. Front Psychol, 2026, 17: 1699377. doi: 10.3389/fpsyg.2026.1699377.
[29]	Alanazi MO, Deka P, Given CW, et al. Coping strategies and health-related quality of life in individuals with heart failure[J]. J Clin Med, 2025, 14(9): 3073. doi: 10.3390/jcm14093073.
[30]	Wang Z, Xu D, Yu S, et al. Effectiveness of meaning-centered interventions on existential distress and mental health outcomes in cancer survivors and their family caregivers: A systematic review and meta-analysis of randomized controlled trials[J]. Worldviews Evid Based Nurs, 2025, 22(1): e12752. doi: 10.1111/wvn.12752.
[31]	Aiello-Puchol A, García-Alandete J. A systematic review on the effects of logotherapy and meaning-centered therapy on psychological and existential symptoms in women with breast and gynecological cancer[J]. Support Care Cancer, 2025, 33: 465. doi: 10.1007/s00520-025-09519-1. pmid: 40347318
[32]	Lertsuwan K, Soonthornchaiya R, Bunthumporn N. Effects of a meaning in life enhancement program on depression among older adult residents of assisted living facilities[J]. Geriatr Nurs, 2025, 61: 287-292. doi: 10.1016/j.gerinurse.2024.11.015. pmid: 39566239
[33]	Martínez O, Montoya MJ, del Castillo C, et al. Effects of a guided digital meaning-centred program on meaning in life, depression and anxiety levels: A pilot study in an Ibero-American sample[J]. Couns Psychother Res, 2026. doi: 10.1002/capr.70158.
[34]	Alsaadi F, Maldonado MA, Erfanikia M, et al. Systematic review of search for meaning in life assessment tools: Highlighting the need for a quest for significance scale[J]. Front Psychol, 2025, 16: 1513720. doi: 10.3389/fpsyg.2025.1513720.
[35]	Li Y, Xiong X, Wang H, et al. Positive psychological experiences in chronic heart failure: A qualitative meta-synthesis[J]. J Adv Nurs, 2025, 81: 8564-8578. doi: 10.1111/jan.16824.
[36]	Maukel LM, Bouchard K, Liu PP, et al. The heart's silver lining: Positive psychological well-being and health related quality of life in patients with heart failure[J]. Gen Hosp Psychiatry, 2025, 95: 11-18. doi: 10.1016/j.genhosppsych.2025.03.014.
[37]	秦振琳, 贾海玉. 老年综合评估在慢性心力衰竭合并焦虑抑郁患者中的研究进展[J]. 中国循证心血管医学杂志, 2026, 18(6): 765-768.
[38]	Marco JH, Martinez-Micó A, García-Alandete J, et al. A systematic review of the effectiveness of meaning-centred psychotherapies in depressed participants[J]. Clin Psychol Psychother, 2024, 31(1): e2936. doi: 10.1002/cpp.2936.
[39]	Kohlert A, Gallant NL, Hill TG, et al. Existential therapy for treating chronic pain:A scoping review[J]. Appl Psychol Health Well-Being, 2025, 17(6): e70093. doi: 10.1111/aphw.70093.
[40]	Gelfman LP, Blum M, Ogunniyi MO, et al. Palliative care across the spectrum of heart failure[J]. JACC Heart Fail, 2024, 12(6): 973-989. doi: 10.1016/j.jchf.2024.01.010.
[41]	Yang S, Jiang Y, Wang C, et al. Palliative care in advanced heart failure: Systematic review and meta-analysis[J]. BMJ Support Palliat Care, 2026, 16(3): 548-557. doi: 10.1136/spcare-2025-005527.
[42]	Corbella G, Pierobon A, Maffoni M. What is life worth living for? A systematic review on meaning in life and meaning in work as protective factors for healthcare professionals' wellbeing[J]. Health Psychol Rep, 2025, 13(2): 111-132. doi: 10.5114/hpr/199541. pmid: 40487475