TY - JOUR
T1 - Effects of cognitive behavioural therapy for depression in heart failure patients
T2 - a systematic review and meta-analysis
AU - Jeyanantham, Kishaan
AU - Kotecha, Dipak
AU - Thanki, Devsaagar
AU - Dekker, Rebecca
AU - Lane, Deirdre A.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - 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.
AB - 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.
KW - Cognitive behavioural therapy
KW - Depression
KW - Heart failure
KW - Meta-analysis
KW - Quality of life
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85025441042&partnerID=8YFLogxK
U2 - 10.1007/s10741-017-9640-5
DO - 10.1007/s10741-017-9640-5
M3 - Review Article
AN - SCOPUS:85025441042
SN - 1382-4147
VL - 22
SP - 731
EP - 741
JO - Heart Failure Reviews
JF - Heart Failure Reviews
IS - 6
ER -