School of Medicine investigators report that depression can be treated successfully with psychotherapy in patients with coronary artery disease or related heart problems.
In a March 9 presentation at the annual meeting of the American Psychosomatic Society in Williamsburg, Va., the researchers reported that cognitive behavior therapy (CBT) appears to be as effective in heart patients as in healthy people. They are the first to test CBT for depression in cardiac patients.
"Depression is a very serious problem for people who have heart disease," explained Kenneth E. Freedland, Ph.D., lead investigator and associate professor of medical psychology in psychiatry.
Unfortunately, Freedland said, many heart patients never are diagnosed as depressed. "Because they are often so sick, symptoms of depression can be mistaken for manifestations of heart disease," he explained. "Not only does depression make people feel sad, but if left untreated, it increases their risk of a serious heart attack."
Anti-depressant medications are helpful, but they must be used carefully in patients with heart disease. Some cannot tolerate the drugs, and others prefer not to take them. So Freedland said it is important to find alternative therapies such as CBT.
Freedland and Robert M. Carney, Ph.D., professor of medical psychology in psychiatry, treated 23 depressed patients with a 16-week course of CBT. Each week, patients were asked to complete a questionnaire that measures depression. Of those who completed the therapy, all were rated as non-depressed when measured by the questionnaire, called the Beck Depression Inventory (BDI). In patients still undergoing treatment, BDI numbers declined, meaning their depression improved.
"This is a small sample, and a larger, controlled study is needed before we can say the therapy is truly effective," Freedland noted. But the results look promising, and the payoff could be big. "We hope to learn whether treating depression actually lowers the risk of heart attack and premature death in these patients. That's still an open question," he added.
-- Jim Dryden
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