Behavioral therapies help heart failure patients fight depression

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Heart failure patients are more than twice as likely to be depressed than are healthy adults and what s more, depressive symptoms double these patients risk of hospital readmission and triple their risk of death from heart failure. It is promising news, then, that research just presented at the Heart Failure Society of America meeting has found that heart failure patients can benefit from a combination of cognitive behavioral therapy (CBT) and biofeedback. The results showed that the combined treatment reduced the risk of cardiac hospitalization or death by nearly two-fold.

As ACSH s Dr. Josh Bloom explains, CBT is not simply talk therapy it is a much more systematic form of counseling that aims to change patterns of thought and behavior. When combined with effective relaxation techniques, these treatments can be quit efficacious in helping to treat depression.

For this study, about 300 patients were randomized to receive weekly one-hour therapy sessions over six weeks that included either CBT along with biofeedback relaxation therapy, just CBT, or usual care alone. After one year of follow-up, those in the active intervention group saw the biggest drop in depression, which fell to 13.3 percent from an initial rate of 25 percent. During the same time period, patients who received only CBT or usual care actually saw slightly higher rates of depression.

Lead author Dr. Debra K. Moser of the University of Kentucky in Lexington believes CBT and other forms of relaxation therapy are useful tools that may more effectively treat depression among heart failure patients, especially since drug therapy hasn t been shown to sever the link between depression and poor outcomes, she says.

But Dr. Javed Butler of Emory University, the meeting moderator, questions whether the findings were a result of the intervention itself, or if the study therapist, who made a strong personal connection to the patients, may have been the factor most responsible for the positive outcomes. Nevertheless, the authors maintain that CBT is worth investigating further and can provide a sound alternative to drug treatment.

Heart failure is a chronic disease, adds ACSH s Dr. Ruth Kava. It follows that patients suffering from this condition should be open to trying alternative modalities to treat related depression, including CBT.