Determinants of depressive symptoms in patients with heart failure based on the hopelessness theory of depression.

In patients with heart failure, symptom burden, decreased optimism, and hopelessness contribute to depressive symptoms directly. What's more, decreased optimism and maladaptive cognitive emotion regulation strategies lead to depressive symptoms indirectly via hopelessness. Accordingly, interventions aimed at decreasing symptom burden, enhancing optimism, and reducing the use of maladaptive cognitive emotion regulation strategies while declining hopelessness, may be conducive to relieving depressive symptoms in patients with heart failure.