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Psychological Interventions for Coronary Heart Disease: Cochrane Systematic Review and Meta-analysis

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Abstract

Background

Depression and anxiety are common in cardiac patients, and psychological interventions may also be used as part of general cardiac rehabilitation programs.

Purpose

This study aims to estimate effects of psychological interventions on mortality and psychological symptoms in this group, updating an existing Cochrane Review.

Method

Systematic review and meta-regression analyses of randomized trials evaluating a psychological treatment delivered by trained staff to patients with a diagnosed cardiac disease, with a follow-up of at least 6 months, were used.

Results

There was no strong evidence that psychological intervention reduced total deaths, risk of revascularization, or non-fatal infarction. Psychological intervention did result in small/moderate improvements in depression and anxiety, and there was a small effect for cardiac mortality.

Conclusion

Psychological treatments appear effective in treating patients with psychological symptoms of coronary heart disease. Uncertainty remains regarding the subgroups of patients who would benefit most from treatment and the characteristics of successful interventions.

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Acknowledgments

We would like to acknowledge all the authors who provided additional information on request and Cornelia Junghans for Russian and German translations. Ben Whalley was supported by an ESRC fellowship (PTA-026-27-2113). We also wish to acknowledge the authors of the original Cochrane review as follows: Karen Rees, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK; Philippa Davies, Academic Unit of Psychiatry, School of Social and Community Medicine, University of Bristol, Bristol, UK; Paul Bennett, Department of Psychology, University of Swansea, Swansea, UK; Shah Ebrahim, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; Zulian Liu, Peninsula Medical School, University of Exeter, Exeter, UK; Robert West, Wales Heart Research Institute, Cardiff University, Cardiff, UK; and Tiffany Moxham, Wimberly Library, Florida Atlantic University, Boca Raton, Florida, USA. The study was funded by a UK National Institute for Health Research Cochrane Programme Grant (CPG510).

Conflict of Interest

None.

Author information

Authors and Affiliations

  1. School of Psychology, University of Plymouth, Plymouth, UK

    Ben Whalley

  2. Cardiovascular Research Centre (CvRC), Australian Catholic University, Melbourne, Australia

    David R. Thompson

  3. Peninsula College of Medicine and Dentistry, Universities of Exeter and Plymouth, Veysey Building, Salmon Pool Lane, Exeter, EX2 4SG, UK

    Rod S. Taylor

Authors
  1. Ben Whalley
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  2. David R. Thompson
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  3. Rod S. Taylor
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Corresponding author

Correspondence to Rod S. Taylor.

Additional information

A version of this article has been accepted and published by the Cochrane Review Group, December 2011 [citation, Whalley B, Rees K, Davies P, Bennett P, Ebrahim S, Liu Z, West R, Moxham T, Thompson DR, Taylor RS. Psychological interventions for coronary heart disease. Cochrane Database of Systematic Reviews. 2011;8(art no CD002902). doi:10.1002/14651858.CD002902.pub3].

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Whalley, B., Thompson, D.R. & Taylor, R.S. Psychological Interventions for Coronary Heart Disease: Cochrane Systematic Review and Meta-analysis. Int.J. Behav. Med. 21, 109–121 (2014). https://doi.org/10.1007/s12529-012-9282-x

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