Group Therapy Can Provide Long-lasting Relief of Anxiety in Patients With Heart Conditions

Heart patients who attended group therapy experienced less psychological distress and improved quality of life, according to research published in the European Heart Journal. After 1 year, patients even had a 57% lower risk of being readmitted to the hospital for heart problems.

“The findings indicate that all patients attending cardiac rehabilitation should be screened for psychological distress and offered [cognitive behavioral therapy (CBT)] if needed. Those in the therapy group said it was a relief being with others dealing with the same problems,” said study author Annette Holdgaard, a nurse at Copenhagen University Hospital – Bispebjerg and Frederiksberg, Denmark, in a press release.

Psychological symptoms, such as heart palpitations and chest discomfort, can reflect cardiac symptoms. This can causes patients much distress and affect their ability to live with a higher quality of life, explains Holdgaard.

“Approximately 20% of all cardiac patients have signs of psychological distress, rising to one-third of employed patients,” said Holdgaard in the press release.

While heart patients have previously been referred to a therapist or psychologist for help, it is difficult to use in daily life. The study aimed to assess the effects of CBT in a group setting for patients with symptoms of anxiety or depression. The team looked at 147 working aged patients with cardiac conditions who were suffering from psychological distress, according to the Hospital Anxiety and Depression Scale (HADS).

Participants were randomized into 2 groups. The first group received CBT and cardiac rehabilitation—which included exercise, medication adjustment, and education about modifiable risk factors, such as diet, smoking, physical activity, body weight, blood sugar, and blood pressure, while the control group only received cardiac rehabilitation.

The CBT group participated in five 2-hour CBT sessions led by trained nurses. Each CBT session included groups of 3 to 4 patients. The nurses led guided discussions about the participants’ personal values, anxiety and coping strategies, behaviors and their consequences, dealing with concerns, and learning how to deal with future stressors.

The data showed that interventions for patients with heart conditions and psychological distress were effective, while “also illustrat[ing] the importance of individualizing rehabilitation programs to meet the needs of different patient groups,” Christi Deaton, professor at the University of Cambridge, UK, and spokesperson for the European Heart Journal, said in the press release.

CBT was also shown to improve quality of life at 6 months, and the researchers found that CBT was the most preferred type of cardiac rehabilitation among participants. Additionally, scores on the HADS model were significantly higher in the CBT group compared to the control group (8 and 4.1, respectively). Further, the significant improvement in anxiety and depression symptoms endured at the 6-month follow up point.

“This study is important for multiple reasons [and] the results of this study and others show that group CBT is a promising intervention in patients with cardiovascular conditions and psychological distress,” Deaton said in the press release.

Reference

European Society of Cardiology. Talking therapies reduce anxiety and depression in working age heart patients. News Release.January 17, 2023. Accessed on January 18, 2023. https://www.eurekalert.org/news-releases/976724