Patients with CVD have reduced depression with CBT

  • Reavell J & al.
  • Psychosom Med
  • 1 Oct 2018

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Cognitive-behavioral therapy (CBT) effectively reduces depression and anxiety in patients who have cardiovascular disease (CVD), according to this systematic review and meta-analysis.
  • At least 5 hours of CBT are needed.

Why this matters

  • Poor mental health is linked to worse CVD outcomes, and depression and anxiety are both common in people with CVD.
  • The authors say previous reviews involved only limited CVD patient populations.

Key results

  • Compared with control patients, patients having CBT had reduced anxiety and depression scores (standard mean difference [SMD]):
    • Depression (n=2254): −0.35 (95% CI, −0.52 to −0.17; P<.001>
      • OR for depression postintervention vs control patients: 0.29 (95% CI, 0.12-0.69: P=.005).
    • Anxiety (n=605): −0.34 (95% CI, −0.65 to −0.03, P=.03).
  • QoL related to mental health also improved more for patients receiving CBT:
    • MD, 3.62 (95% CI, 0.22-7.02; P=.04).
  • Cardiovascular event odds (OR, 0.80; 95% CI, 0.33-1.93) and patient satisfaction (SMD, 0.11; 95% CI, −0.29 to 0.51) did not differ significantly with CBT intervention.

Study design

  • Meta-analysis, systematic review, 12 articles (randomized controlled trials, Western, mostly white male populations).
  • Pooled data were analyzed.
  • Funding: Some authors report industry funding.

Limitations

  • Some studies had adjunctive use of antidepressants.
  • 2 included studies did not use standard care as the comparator.
  • Blinding not possible.

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