期刊
DISABILITY AND REHABILITATION
卷 37, 期 7, 页码 585-592出版社
TAYLOR & FRANCIS LTD
DOI: 10.3109/09638288.2014.935493
关键词
Anti-depressant; anxiolytic; cognitive behavioral therapy; exercise major depression disorder; generalized anxiety disorder; heart failure
资金
- NHMRC Early Career Fellowship grant
Purpose: No previous study has reported upon comorbid depression and anxiety disorders and their treatment in heart failure (HF), which the current study has sought to document. Materials and methods: Total 29 HF patients under psychiatric management underwent primary depression cognitive behavioral therapy (CBT; n = 15) or primary generalized anxiety disorder (GAD) CBT (n = 14), and participated in a community exercise program and standard physician care. Repeated measures analysis of variance assessed Patient Health Questionnaire (PHQ-9) and GAD-7 symptom change pre- and post-CBT treatment, and assessed the interaction effects of treatment type, exercise, anti-depressant and anxiolytic. Results: There was a significant time and treatment interaction effect that favored the primary GAD CBT group for reduction in PHQ symptoms (F(1, 24) = 4.52, p = 0.04). Analysis of PHQ-somatic symptoms also showed a significant main effect for participation in the exercise program (F(1, 24) = 4.21, p = 0.05) and a significant time and anxiolytic interaction (F(1, 24) = 3.98, p = 0.05). The average number of cardiac hospital readmissions favored the primary GAD CBT group (p = 0.05). Conclusion: The findings support the use of multifaceted interventions in the rehabilitation of HF patients with comorbid psychiatric needs.
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