Effects of cognitive behavioural therapy for depression in heart failure patients: a systematic review and meta-analysis

Kishaan Jeyanantham, Dipak Kotecha, Devsaagar Thanki, Rebecca Dekker, Deirdre A. Lane*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

92 Citations (Scopus)
298 Downloads (Pure)

Abstract

This systematic review and meta-analysis aimed to evaluate the effects of cognitive behavioural therapy (CBT) on depression, quality of life, hospitalisations and mortality in heart failure patients. The search strategy was developed for Ovid MEDLINE and modified accordingly to search the following bibliographic databases: PubMed, EMBASE, PsycINFO, CENTRAL and CINAHL. Databases were searched from inception to 6 March 2016 for randomised controlled trials (RCTs) or observational studies that used CBT in heart failure patients with depression or depressive symptoms. Six studies were identified: 5 RCTs and 1 observational study, comprising 320 participants with predominantly NYHA classes II-III, who were mostly male, with mean age ranging from 55 to 66 years. Compared to usual care, CBT was associated with a greater improvement in depression scores both initially after CBT sessions (standardised mean difference −0.34, 95% CI −0.60 to −0.08, p = 0.01) and at 3 months follow-up (standardised mean difference −0.32, 95% CI −0.59 to −0.04, p = 0.03). Greater improvement in quality of life scores was evident for the CBT group initially after CBT sessions, but with no difference at 3 months. Hospital admissions and mortality were similar, regardless of treatment group. CBT may be more effective than usual care at improving depression scores and quality of life for heart failure patients initially following CBT and for depression at 3 months. Larger and more robust RCTs are needed to evaluate the long-term clinical effects of CBT in heart failure patients.

Original languageEnglish
JournalHeart Failure Reviews
Volume22
Issue number6
Pages (from-to)731-741
Number of pages11
ISSN1382-4147
DOIs
Publication statusPublished - 2017

Keywords

  • Cognitive behavioural therapy
  • Depression
  • Heart failure
  • Meta-analysis
  • Quality of life
  • Systematic review

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