Reduced psychological distress three months after intensive group-based cognitive therapy in cardiac patients

Abstract

Background/Introduction: Patients with coronary artery disease (CAD) and valvular heart disease (VHD) often suffer from psychological distress, which in turn leads to impaired quality of life, delayed return to work and increased morbidity and mortality. Manageable interventions addressing psychological distress in cardiac patients are needed. Purpose: To develop an efficient and cost-effective model for cardiac patients to reduce psychological distress. Methods: A multi-centre, prospective, randomized clinical trial in patients with newly diagnosed CAD and/or surgically treated VHD and concomitant psychological distress defined as Hospital Anxiety and Depression (HADS A(Anxiety) or D(Depression) ≥8) and part of the work force. The patients were randomized to either usual out-patient cardiac rehabilitation (CR) comprising an 8-week multidisciplinary program or usual care supplemented by five group-based cognitive therapy sessions performed by trained CR nurses. The primary outcome was total HADS score at three months. Results: We included 147 patients with HADS score >=8; mean age was 55, 74% were male and 92% had CAD (Table 1). At three months, total HADS score improved by 8 (CI: 8.0-10.7) in the intervention versus 3,9 (CI: 11.8-15.4) in the usual care group (p for difference <0.001). Both subscales, anxiety and depression improved significantly more in the intervention group (Figure 1). Conclusion: Brief cognitive behavioral therapy provided by cardiac nurses to patients with a high HADS score significantly reduced psychological destress after 3 months when compared to usual care. (Table Presented).