Article

No previous study has reported upon comorbid depression and anxiety
disorders and their treatment in heart failure (HF), which the current study has
sought to document. METHODS: Total 29 HF patients under psychiatric
management underwent primary depression cognitive behavioral therapy (CBT; n =
15) or primary generalized anxiety disorder (GAD) CBT (n = 14), and participated
in a community exercise program and standard physician care. Repeated measures
analysis of variance assessed Patient Health Questionnaire (PHQ-9) and GAD-7
symptom change pre- and post-CBT treatment, and assessed the interaction effects
of treatment type, exercise, anti-depressant and anxiolytic. RESULTS: There was a
significant time and treatment interaction effect that favored the primary GAD
CBT group for reduction in PHQ symptoms (F(1, 24) = 4.52, p = 0.04). Analysis of
PHQ-somatic symptoms also showed a significant main effect for participation in
the exercise program (F(1, 24) = 4.21, p = 0.05) and a significant time and
anxiolytic interaction (F(1, 24) = 3.98, p = 0.05). The average number of cardiac
hospital readmissions favored the primary GAD CBT group (p = 0.05). CONCLUSION:
The findings support the use of multifaceted interventions in the rehabilitation
of HF patients with comorbid psychiatric needs. Implications for Rehabilitation
Comorbid depression and anxiety disorders are a clinical and research focus that
deserves more attention in the treatment of heart failure patients. Cognitive
behavioral therapy, exercise, and anxiolytic use was associated with significant
changes in depression and anxiety though discrete effects were evident.
Multifaceted interventions are most likely to be successful in the rehabilitation
of HF patients with psychiatric needs.

Langue : ANGLAIS