The incidence and prevalence of congestive heart failure (CHF) are increasing, even after adjustment for an aging population. Because coverage of psychosocial factors in CHF has been insufficient, we reviewed the literature in this area. Four major themes emerged in our review as we examined relations between psychosocial factors and CHF: psychiatric comorbidity, psychosocial precipitation and exacerbation of CHF, psychosocial consequences of CHF, and physiological mechanisms linking psychosocial factors and the course of CHF. There is a surprising paucity of studies in these areas. We tabulate the studies and discuss representative studies with an eye to directions for future research. [ABSTRACT FROM AUTHOR]