Ski, C.F., Taylor, R.S., McGuigan, K. et al. (4 more authors) (2025) Psychological interventions for depression and anxiety in patients with coronary heart disease, heart failure or atrial fibrillation: Cochrane systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 24 (2). pp. 194-204. ISSN 1474-5151
Abstract
Aims Depression and anxiety occur frequently in individuals with cardiovascular disease and are associated with poor prognosis. This Cochrane systematic review and meta-analysis assessed the effectiveness of psychological interventions on psychological and clinical outcomes in adults with coronary heart disease (CHD), heart failure (HF) or atrial fibrillation (AF).
Methods and results CENTRAL, MEDLINE, Embase, PsycINFO, and CINAHL databases were searched from January 2009 to July 2022 for randomized controlled trials of psychological interventions vs. controls in adults with CHD, HF, or AF. Twenty-one studies (n = 2591) were assessed using random-effects models. We found psychological interventions reduced depression [standardized mean difference (SMD) −0.36; 95% confidence interval (CI) −0.65 to −0.06; P = 0.02], anxiety (SMD −0.57; 95% CI −0.96 to −0.18; P = 0.004), and improved mental health-related quality of life (HRQoL) (SMD 0.63, 95% CI 0.01 to 1.26; P = 0.05) (follow-up 6–12 months), but not physical health-related quality of life, all-cause mortality or major adverse cardiovascular events compared with controls. High heterogeneity was present across meta-analyses. Meta-regression analysis showed that psychological interventions designed to target anxiety, were more effective than non-targeted interventions.
Conclusion This review found that psychological interventions improved depression, anxiety and mental HRQoL, with those targeting anxiety to show most benefit. Given the statistical heterogeneity, the precise magnitude of effects remains uncertain. Increasing use of multifactorial psychological interventions shows promise for incorporating patient needs and preferences. Investigation of those at high risk of poor outcomes, comparison of intervention components and those with AF is warranted.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2024. This is an open access article under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. |
Keywords: | Anxiety, Atrial fibrillation, Coronary heart disease, Depression, Heart failure, Meta-analysis, Psychological interventions |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 30 May 2025 09:44 |
Last Modified: | 30 May 2025 09:44 |
Status: | Published |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/eurjcn/zvae113 |
Related URLs: | |
Sustainable Development Goals: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:227217 |