Background The impact of psychosocial states, such as depression or anxiety, and social support on the outcomes of stable outpatients with mild heart failure (HF) has not been evaluated in the "real world" clinical practice. Methods and Results In the present study, 139 patients with a prior history of admission for HF provided the baseline demographic, clinical, socio-environmental, and psychosocial information. Cardiac death or re-admission because of worsening of HF was monitored during the follow-up period of 1 year. The prevalence of depression and anxiety were 37% and 37%, respectively, in HF patients. Depression was independently associated with male (sβ=-0.36, P=0.01), social ties (sβ=0.22, P=0.04) and low social support (sβ=-0.39, P<0.01). Anxiety was associated with alcohol drinking (sβ=0.22, P=0.04), brain natriuretic peptide ≥200 pg/dl (sβ=0.35, P<0.01), and low social support (sβ=-0.28, P=0.01). Kaplan-Meier analysis demonstrated that patients with anxiety (log-lank test; P<0.01) and lower scores of social support (P<0.01) had a higher rate of HF-related re-admission. Conclusions Anxiety and low social support were independently associated with HF-related re-admission, which indicates the need for their inclusion in the assessment and management of HF. (Circ J 2009; 73: 280 - 287)