Psychosocial interventions for patients with coronary heart disease and depression: A systematic review and meta-analysis

Chantal F. Ski, Michael Jelinek, Alun C. Jackson, Barbara M. Murphy, David R. Thompson*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

22 Citations (Scopus)

Abstract

Introduction: Depression is common in patients with coronary heart disease, and together these conditions significantly affect health outcomes. Impaired social support is also considered an important predictor of coronary heart disease prognosis and, as there is a complex interplay between social isolation and depression, interventions to address both may be required. This review aimed to assess the effectiveness of psychosocial interventions addressing both depression and social support for people with coronary heart disease and depression.

Methods: PRISMA guidelines were used to search major health databases to identify randomised controlled trials that evaluated psychosocial interventions compared with usual care in patients with coronary heart disease and depression; the primary outcome was depressive symptoms and secondary outcomes were mortality (all-cause and cardiac), myocardial infarction, revascularisation, anxiety, social support and quality of life. Data, when suitable, were pooled using a random-effects meta-analysis model.

Results: Five studies (n=1358 participants) were eligible and included. The psychosocial intervention group had significantly lower levels of depressive symptoms (standardised mean difference (SMD) -0.15, 95% confidence interval (CI) -0.27 to -0.03; P=0.02) and higher levels of social support (SMD 0.17; 95% CI 0.04 to 0.30; P=0.01) but no differences were found for mortality (all-cause and cardiac), myocardial infarction, revascularisation, anxiety or quality of life.

Conclusions: Psychosocial interventions for patients with coronary heart disease and depression result in modest reductions in depressive symptoms and improvements in social support. However, caution is warranted in view of the small number of studies included in the review and potential heterogeneity in outcomes and in differences in treatment.
Original languageEnglish
Pages (from-to)305-316
Number of pages12
JournalEuropean Journal of Cardiovascular Nursing
Volume15
Issue number5
Early online date16 Oct 2015
DOIs
Publication statusPublished - 01 Aug 2016

Keywords

  • coronary heart disease
  • depression
  • meta-analysis
  • Psychosocial interventions
  • systematic review

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medical–Surgical
  • Advanced and Specialised Nursing

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