Efficacy of mindfulness-based cognitive therapy on symptoms of depression and anxiety in patients with coronary artery disease: insights from a prospective registry

Abstract

Introduction: Patients with coronary artery disease (CAD) report psychological distress and poor physical functioning after cardiovascular events. In cardiac rehabilitation, an exercise program is often used as A primary strategy; however, this is often not sufficient to address stress and psychosocial well-being. Purpose: To investigate the effectiveness of a mindfulness-based cognitive therapy (MBCT) program on feelings of anxiety and depression in patients with CAD. Methods: In this single-center prospective observational study, eligible cardiac rehabilitation patients with symptoms of anxiety or depression were recruited after referral for psychological consultation. During eight consecutive weeks, patients participated in group meetings. The program included psycho-education, cognitive behavioral therapy, meditation and slow abdominal breathing. Standard measures of depression, anxiety and blood pressure were obtained at baseline and after completion of the program. The Hospital Anxiety and Depression Scale (HADS) questionnaire was used as an instrument for detecting states of anxiety and depression. Results: A total of 135 patients (mean age 56±9 years; 24% female) were enrolled. The mean HADS-Anxiety score improved from 11.0±3.7 at baseline to 6.6±3.4 after MBCT (p<0.001). The mean HADS-Depression score improved from 8.8±3.6 to 4.7±3.2 (p<0.001). In addition, during the MBCT program a significant decrease in blood pressure was noted: systolic from 140±18 to 130±17 mmHg and diastolic from 84±12 to 77±10 mmHg (p<0.001 for both). Conclusion: This study provides evidence that a MBCT program has the potential to improve feelings of anxiety and depression in patients with CAD. Therefore, adding MBCT to cardiac rehabilitation in selected patients may be of great value.