NEW YORK (Reuters Health) - Cognitive behavior therapy, and to a lesser extent supportive stress management, decrease depression in patients who have had heart bypass surgery, a study shows. Antidepressants, on the other hand, appear to have little effect in this patient population.
About one in every five patients suffers a major bout of depression following heart bypass surgery and at least that many develop milder forms of depression, Dr. Kenneth F. Freedland, at Washington University School of Medicine in S. Louis, and co-investigators note in the current issue of Archives of General Psychiatry.
In a study of 123 depressed bypass patients, the researchers randomized 41 to cognitive behavior therapy, 42 to supportive stress management, and 40 to "usual" care. About half the patients in each group were taking antidepressants.
After 3 months, 71 percent of patients in the cognitive behavior therapy group and 57 percent in the supportive stress management group saw their depression lift, compared to just 33 percent of patients in the usual care group.
The differences narrowed at the 6-month follow-up but differed again at 9 months (73 percent for the cognitive behavior therapy group, 57 percent for the supportive stress management group and 35 percent for the usual care group).
"Cognitive behavior therapy," the investigators report, "was also superior to usual care on most secondary psychological outcomes, including anxiety, hopelessness, perceived stress and the mental (but not the physical) component of health-related quality of life. Supportive stress management was superior to usual care only on some of these measures."
In this study of heart bypass patients, antidepressant medication had no effect on the outcome of depression.
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