Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2005 Jan 25;2005(1):CD003329.
doi: 10.1002/14651858.CD003329.pub2.

Psychological interventions for depression in heart failure

D A Lane  1 , A Y Chong, G Y H Lip
Affiliations

Psychological interventions for depression in heart failure

D A Lane et al. Cochrane Database Syst Rev. .

Abstract

Background: Heart failure is a common and growing health problem. Depression is prevalent among these patients and is associated with an increased risk of mortality, in some, but not all, studies. Depression may increase the risk of recurrent cardiac events and death, either through direct pathophysiological mechanisms such as thrombogenesis or ventricular arrhythmias, or through behavioural mechanisms. Depressed patients are less likely to adhere to their medication regimen and modify their lifestyle appropriately, thereby increasing the likelihood of recurrent cardiac events and death. The effects of psychological interventions for depression in terms of reducing depression and improving prognosis in patients with heart failure are unknown.

Objectives: To assess the effects of psychological interventions for depression in people with heart failure on depression and quality of life, morbidity, and mortality in these patients.

Search strategy: We searched the Cochrane Central Register of Controlled Trials and The Database of Abstracts of Reviews of Effects on The Cochrane Library (Issue 3, 2003), MEDLINE (1951 to August 2003), PsycINFO (1887 to August 2003), CINAHL (1980 to August 2003) and EMBASE (1980 to August 2003). Searches of reference lists of retrieved papers were also made and expert advice was sought. Abstracts from national and international cardiology, psychology, and psychiatry conferences in 2003 and dissertation abstracts were also searched. All relevant foreign language papers were translated.

Selection criteria: RCTs of psychological interventions for depression in adults (18 years or older) with heart failure. The primary outcome was a significant reduction in depression. The secondary outcomes were the acceptability of treatment, quality of life, cardiac morbidity (hospital re-admission for heart failure and non-fatal cardiovascular events), reduction of cardiovascular behavioural risk factors, health economics, and death.

Data collection and analysis: Two reviewers independently screened titles and abstracts of potential studies. Two reviewers independently assessed the full papers for inclusion criteria. Further information was sought from the authors where papers contained insufficient information to make a decision about eligibility.

Main results: No RCTs of psychological interventions for depression in patients with heart failure were identified.

Authors' conclusions: Depression is common among patients with heart failure. Randomised controlled trials of psychological interventions for depression in heart failure patients are needed to investigate the impact of such interventions on depression, quality of life, behavioural CVD risk factors, cardiac morbidity, health economics and mortality, given the paucity of such trials in this area and the increasing prevalence of heart failure.

PubMed Disclaimer

Conflict of interest statement

None known

Figures

1
1
QUOROM statement flow diagram
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD003329

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies excluded from this review

Hawthorne 1994 {published data only}
    1. Hawthorne MH, Hixon ME. Functional status, mood disturbance and quality of life in patients with heart failure. Progress in Cardiovascular Nursing 1994;9:22-32. - PubMed
Jaarsma 2003 {published data only}
    1. Jaarsma T, Veldhuisen DJ. Effectiveness of heart failure clinics in the Netherlands: Research program set-up [Onderzoek opgezet naar het effect van hartfalenpoliklinieken in Nederland]. Nederlands Tijdschrift voor Geneeskunde 2003;147:513-4. - PubMed
Konstam 1999 {published data only}
    1. Konstam V, Hurley L, Hijjazi K, Perry K, Konstam MA. Positive affect: A neglected group treatment outcome in assessing efficacy of psychosocial group interventions in individuals with heart failure. Group 1999;23:37-46.
Kostis 1994 {published data only}
    1. Kostis JB, Rosen RC, Cosgrove NM, Shindler DM, Wilson AC. Nonpharmacologic therapy improves functional and emotional status in congestive heart failure. Chest 1994;106:996-1001. - PubMed
Luskin 2002 {published data only}
    1. Luskin F, Reitz M, Newell K, Quinn TG, Haskell W. A controlled pilot study of stress management training of elderly patients with congestive heart failure. Preventive Cardiology 2002;5:168-172. - PubMed
McCraty 2002 {published data only}
    1. McCraty R. Effects of an emotional restructuring program on psychological functioning and functional capacity in patients with congestive heart failure. International Journal of Psychophysiology 2002;5:168-72.
Nelson 2001 {published data only}
    1. Nelson EA, Jordan DM, II. Preliminary results of a pilot program on depression in patients with congestive heart failure. Psychological Reports 2001;88:42-4. - PubMed

Additional references

Abramson 2001
    1. Abramson J, Berger A, Krumholz HM, Vaccarino V. Depression and risk of heart failure among older persons with isolated systolic hypertension. Archives of Internal Medicine 2001;161:1725-30. - PubMed
Adams 1998
    1. Adams KF, Zannad F. Clinical definition and etiology of advanced heart failure. American Heart Journal 1998;135:S204-S215. - PubMed
Ahern 1990
    1. Ahern DK, Gorkin L, Anderson JL, Tierney C, Hallstrom A, Ewart C, et al for the CAPS Investigators. Biobehavioural variables and mortality or cardiac arrest in the Cardiac Arrhythmias Pilot Study (CAPS). American Journal of Cardiology 1990;66:59-62. - PubMed
Anda 1990
    1. Anda RF, Williamson DF, Escobedo LG, Mast EE, Giovino GA, Remington PL. Depression and the dynamics of smoking: a national perspective. Journal of the American Medical Association 1990;264:1541-5. - PubMed
APACNS 1994
    1. American Psychiatric Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 4th edition. Washington DC: American Psychiatric Association, 1994.
Barefoot 1996
    1. Barefoot JC, Helms MJ, Mark DB, Blumenthal JA, Califf RM, Haney TL et al. Symptoms of depression, acute myocardial infarction, and total mortality in a community sample. Circulation 1996;93:1976-80. - PubMed
Berkman 2003
    1. Berkman LF, Blumenthal J, Burg M, Carney RM, Catellier D, Cowan MJ et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. Journal of the American Medical Association 2003;289:3106-16. - PubMed
Blumenthal 1982
    1. Blumenthal JA, Williams RS, Wallace AG, Williams RB, Needles TL. Physiological and psychological variables predict compliance to prescribed exercise therapy in patients recovering from myocardial infarction. Psychosomatic Medicine 1982;44:519-27. - PubMed
Broadley 2002
    1. Broadley AJM, Korszun A, Jones CJH, Frenneaux MP. Arterial endothelial function is impaired in treated depression. Heart 2002;88:521-3. - PMC - PubMed
Byrne 1993
    1. Byrne A, Byrne DG. The effect of exercise on depression, anxiety and other mood states. Journal of Psychosomatic Research 1993;37:565-74. - PubMed
Carney 1995
    1. Carney RM, Freedland KE, Eisen SA, Rich MW, Jaffe AS. Major depression and medication adherence in elderly patients with coronary artery disease. Health Psychology 1995;14:88-90. - PubMed
Clarke 2002
    1. Clarke M, Oxman A (ed). Cochrane Reviewers Handbook 4.1.5 [updated April 2002]. Vol. 2. Oxford: Update Software, 2002.
Cleland 1995
    1. Cleland JGF, Erdmann E, Ferrari R. Guidelines for the diagnosis of heart failure. The Task Force on Heart Failure of the European Society of Cardiology. European Heart Journal 1995;16:741-51. - PubMed
Davis 2000
    1. Davis RC, Hobbs FDR, Lip GYH. ABC of heart failure: history and epidemiology. British Medical Journal 2000;320:39-42. - PMC - PubMed
Dickersin 1994
    1. Dickersin K, Scherer R, Lefebvre C. Identifying relevant studies for systematic reviews. British Medical Journal 1994;309:1286-91. - PMC - PubMed
Faris 2002
    1. Faris R, Purcell H, Henein M, Coats A. Clinical depression is common and significantly associated with reduced survival in patients with non-ischaemic heart failure. European Journal of Heart Failure 2002;4:541-51. - PubMed
Frasure‐Smith 1993
    1. Frasure-Smith N, Lesperance F, Talajic M. Depression following myocardial infarction. Journal of the American Medication Association 1993;270:1819-25. - PubMed
Frasure‐Smith 1995
    1. Frasure-Smith N, Lesperance F, Talajic M. The impact of negative emotions on prognosis following myocardial infarction: is it more than just depression? Health Psychology 1995;14:388-98. - PubMed
Freedland 1991
    1. Freedland KE, Carney RM, Rich MW, Caracciolo A, Krotenberg JA, Smith LJ et al. Depression in elderly patients with congestive heart failure. Journal of Geriatric Psychology 1991;24:59-71.
Glassman 1990
    1. Glassman AH, Helzer JE, Covey LS, Cottler LB, Stetner F, Tipp JE et al. Smoking, smoking cessation, and major depression. Journal of the American Medication Association 1990;264:1546-9. - PubMed
Grippo 2002
    1. Grippo AJ, Francis J, Weiss RM, Felder RB, Johnson AK. Cytokine mediation of experimental heart failure-induced anhedonia. American Journal of Physiology - Regulatory, Integrative and Comparative Physiology 2002;284:R666-R673. - PubMed
Havranek 1999
    1. Havranek EP, Ware MG, Lowes BD. Prevalence of depression in congestive heart failure. American Journal of Cardiology 1999;84:348-50. - PubMed
Jern 1989
    1. Jern C, Erikksson E, Tengbom L, Risberg B, Wadenvik H, Jern S. Changes of plasma coagulation and fibrinolysis in response to mental stress. Thrombosis and Haemostasis 1989;62:767-71. - PubMed
Jiang 2001
    1. Jiang W, Alexander J, Christopher E, Kuchibhatla M, Gaulden LH, Cuffe MS et al. Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Archives of Internal Medicine 2001;161:1849-56. - PubMed
Jiang 2002
    1. Jiang W, Hasselbad V, Krishnan RR, O'Connor CM. Patients with CHF and depression have greater risk of mortality and morbidity than patients without depression. Journal of the American College of Cardiology 2002;39:919-21. - PubMed
Jones 2001
    1. Jones C, Cormac I, Mota J, Campbell C. Cognitive behaviour therapy for schizophrenia (Cochrane Review). The Cochrane Library 2001, Issue 2. - PubMed
Kiecolt‐Glaser 1992
    1. Kiecolt-Glaser JK, Glaser R. Psychoneuroimmunology: can psychological interventions modulate immunity? Journal of Consulting and Clinical Psychology 1992;60:569-75. - PubMed
Koenig 1998
    1. Koenig HG. Depression in hospitalized older patients with congestive heart failure. General Hospital Psychiatry 1998;20:29-43. - PubMed
Lane 2001
    1. Lane D, Carroll D, Ring C, Beevers DG, Lip GYH. Mortality and quality of life twelve months after myocardial infarction: effects of depression and anxiety. Psychosomatic Medicine 2001;63:221-30. - PubMed
Lane 2002
    1. Lane D, Carroll D, Ring C, Beevers DG, Lip GYH. In-hospital symptoms of depression do not predict mortality 3 years after myocardial infarction. International Journal of Epidemiology 2002;31:1179-82. - PubMed
Mayou 2000
    1. Mayou RA, Gill D, Thompson DR, Day A, Hicks N, Volmink J et al. Depression and anxiety as predictors of outcomes after myocardial infarction. Psychosomatic Medicine 2000;62:212-9. - PubMed
Mendes de Leon 1998
    1. Mendes de Leon CF, Krumholz HM, Seeman TS, Vaccarino V, Williams CS, Kasl SV et al. Depression and risk of coronary heart disease in elderly men and women. Archives of Internal Medicine 1998;158:2341-8. - PubMed
Milani 1996
    1. Milani RV, Lavie CJ, Cassidy MM. Effects of cardiac rehabilitation and exercise training programs on depression in patients after major coronary events. American Heart Journal 1996;132:726-32. - PubMed
Murberg 1999
    1. Murberg TA, Bru E, Svebak S, Tvetaras R, Aarsland T. Depressed mood and subjective symptoms as predictors of mortality in patients with congestive heart failure: A two-years follow-up study. International Journal of Psychiatry in Medicine 1999;29:311-26. - PubMed
Norris 1992
    1. Norris R, Carroll D, Cochrane R. The effects of physical activity and exercise training on psychological stress and well-being in an adolescent population. Journal of Psychosomatic Research 1992;36:55-65. - PubMed
NYHA 1964
    1. New York Heart Association. Diseases of the heart and blood vessels. Nomenclature and criteria for diagnosis. 6th edition. Boston: Little Brown, 1964.
Penninx 1998
    1. Penninx BWJH, Guralnik JM, Ferrucci L, Simonsick EM, Deeg DJH, Wallace RB. Depressive symptoms and physical decline in community-dwelling older persons. Journal of the American Medical Association 1998;279:1720-6. - PubMed
Rees 2004
    1. Rees K, Bennett P, West R, Davey Smith G, Ebrahim S. Psychological interventions for coronary heart disease (Cochrane Review). The Cochrane Library 2004, Issue 3. - PMC - PubMed
Stewart 1989
    1. Stewart AL, Greenfield S, Hays RD, Wells K, Rogers WH, Berry SD et al. Functional status and well-being of patients with chronic conditions: results from the Medical Outcomes Study. Journal of the American Medical Association 1989;262:907-13. - PubMed
Vaccarino 2001
    1. Vaccarino V, Kasl SV, Abramson J, Krumholz HM. Depressive symptoms and risk of functional decline and death in patients with heart failure. Journal of the American College of Cardiology 2001;38:199-205. - PubMed
Wells 1989
    1. Wells KB, Stewart A, Hays RD, Burnam A, Rogers W, Daniels M et al. The functioning and well-being of depressed patients: results from the Medical Outcomes Study. Journal of the American Medical Association 1989;262:914-9. - PubMed
Zuccala 1995
    1. Zuccala G, Cocchi A, Carbonin P. The impact of depression on self-perceived health status. Journal of the American Geriatric Society 1995;43:198-9. - PubMed

Publication types