Cognitive behavioral therapy
program helps depressed cardiac patients embrace healthy behaviors
and a more positive mood
Researchers from the Heart Research Center
in Melbourne, Australia, have demonstrated the benefits of the 8-week
'Beating Heart Problems' group program that helped patients embrace
healthy behaviors and a more positive mood in a randomized controlled
trial presented at the European Society of Cardiology 2011 conference.
According to Principal Research Fellow at the Center, Dr. Barbara
Murphy, depressed participants appear to have benefited from the
contact with their non-depressed peers: "In groups for depressed
patients, progress can be slow. With our program, which involved
depressed and non-depressed patients in a group together, we saw
that the depressed patients improved dramatically. We believe that
the 'well' patients were positive role models for the depressed
patients, helping them to embrace healthy behaviors and a more positive
mood."
After a myocardial infarction or coronary bypass surgery, about
one in four patients experience symptoms of depression. For some,
these symptoms continue on for months and even years. Depressed
patients are more likely to experience another acute event in the
year after their heart attack, and have an increased likelihood
of death in the years to follow. Treating depression is a key step
in preventing disability and premature death.
The Beating Heart Problems program uses principles of cognitive
behavior therapy, which helps patients to identify 'unhelpful thoughts'
and replace them with more helpful ones. "Often it is not the
actual events in our lives but the way we think about those events
that causes low mood or depression" says Dr. Murphy. "The
Beating Heart Problems program helps patients to focus on their
thoughts about their heart attack or heart condition, and come up
with more helpful ways of thinking about it. In the same way, we
can practice more helpful ways of thinking about physical activity,
healthy eating and quitting smoking".
"Another feature of our program is that it is very patient-centered.
We don't tell people which behaviors to change or which thoughts
to think. Patients in the group are encouraged to make the lifestyle
changes that they want to make, and to work at their own pace."
The 8-week program covers eight topics including depression, anxiety
and anger management, physical activity, healthy eating, and smoking
cessation. Depressed patients who attended the 8-week program also
significantly increased their physical activity levels, and had
substantial improvements in the high-density lipoprotein levels,
the 'good' cholesterols in the blood. Increased physical activity
has long been known to improve symptoms of depression, in both cardiac
patients and in the general population. Patients who did not attend
the program did not obtain these benefits.
The study, funded by Australian Rotary Health, the Eirene Lucas
Foundation and Perpetual Trustees, involved 275 patients from the
Royal Melbourne Hospital and Melbourne Private Hospital, both in
Victoria, Australia. All patients had been recently hospitalized
after heart attack or for coronary bypass surgery.
"Overall we are very excited about these findings," says
Dr. Murphy. "Depression is very debilitating for cardiac patients,
and makes their recovery process more protracted and difficult.
Our program helps to make the recovery process easier. And having
non-depressed patients in the group certainly seems to be a strong
point of the program"
|