Relationships between positive psychological constructs and health outcomes in patients with cardiovascular disease: A systematic review.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of prospective observational cohort studies
PubMed 26048390 · doi:10.1016/j.ijcard.2015.05.121
What was done
A systematic review and exploratory random-effects meta-analysis was conducted across PubMed and PsycINFO from inception through January 2014 following established guidelines. Eligible studies were prospective observational cohorts assessing the effects of positive psychological constructs (such as optimism) on subsequent health outcomes (including mortality, rehospitalizations, and self-reported health status) in patients with established cardiovascular disease.
What was found
Across 30 eligible prospective observational studies (77 analyses, N=14,624), 65.0% of all analyses and 64.7% of analyses adjusted for one or more covariates in cohorts with 100+ participants reported a statistically significant (p < .05) positive association with health outcomes. An exploratory meta-analysis of 11 studies demonstrated that positive psychological constructs were significantly associated with reduced rehospitalization or mortality in unadjusted (odds ratio = 0.87, 95% CI [0.83, 0.92], p < .001) and adjusted models (odds ratio = 0.89, 95% CI [0.84, 0.91], p < .001).
Why it matters
This synthesis demonstrates that positive psychological factors, beyond the mere absence of negative states like depression, are prospectively linked to reduced mortality and rehospitalization risk in cardiac patients.
Limits
The included literature consists entirely of observational studies, precluding causal conclusions. The meta-analysis was exploratory, combined different positive constructs and clinical endpoints, and does not delineate which specific psychological traits drive the observed cardiovascular benefit.
Cited by
- supports Studies demonstrate that an optimistic versus pessimistic psychological attitude statistically correlates with differences in disease recovery, life expectancy, and disease-free days.