A pilot study exploring the effects of a 12-week t'ai chi intervention on somatic symptoms of depression in patients with heart failure

Abstract

Background: Patients with chronic heart failure (HF) and with elevated depression symptoms are at greater risk of morbidity and mortality. Somatic symptoms of depression are particularly prevalent in HF and are related to worse disease prognosis. T'ai chi practice is related to increased emotional well-being in various clinical populations; however, relatively little is known about t'ai chi's effects on somatic versus cognitive symptom dimensions of depression in HF.

Purpose: The objective of the study was to measure whether a t'ai chi intervention effectively reduces somatic and/or cognitive symptoms of depression in patients with HF.

Methods: Patients with HF were assigned to either t'ai chi training (n=16) or a usual-care group (n=12). At baseline and after the 12-week intervention period, participants were evaluated for changes in depressive symptoms using Beck Depression Inventory (BDI) total scores (BDI-t) and subcategorized scores of BDI-somatic (BDI-s) and BDI-cognitive (BDI-c), and for symptoms of fatigue using the Multidimensional Fatigue Symptom Inventory-Short Form.

Results: Patients with HF in the t'ai chi group compared to the usual-care group had reduced BDI-s (p≤0.017), but not BDI-c (p=0.50) scores from pre- to postintervention. Although t'ai chi did not significantly reduce fatigue, changes in physical fatigue (p≤0.05) were independently associated with changes in BDI-t scores.

Conclusions: T'ai chi practice reduced somatic symptoms of depression, which have been linked to worse prognosis in HF. Reductions in fatigue appear to explain some but not all of the reductions in somatic symptoms of depression.

FIG. 1.

Changes in Beck Depression Inventory Score (BDI) somatic/affective symptoms (means±standard error of the mean) from T1 (baseline) to T2 (post-12-week intervention period) in patients with heart failure trained in t'ai chi versus usual-care controls.

FIG. 2.

Changes in Beck Depression Inventory Score (BDI) cognitive/affective symptoms (means±standard error of the mean) from T1 (baseline) to T2 (post-12-week intervention period) in patients with heart failure trained in t'ai chi versus usual-care controls.

FIG. 3.

Changes in Beck Depression Inventory Score (BDI) total symptoms (means±standard error of the mean) in patients with heart failure with baseline BDI scores in the top 75% from T1 (baseline) to T2 (post-12-week intervention period) in patients trained in t'ai chi versus usual-care controls.