Cognitive-Behavioral Therapy for Patients with Coronary Artery Disease and Depression: A Systematic Review.

IF 2.4 Q3 CLINICAL NEUROLOGY Clinical Neuropsychiatry Pub Date : 2025-02-01 DOI:10.36131/cnfioritieditore20250103

Mario Miniati, Laura Palagini, Giulia Righi, Donatella Marazziti

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Abstract

Objective: Objective of this review is to summarize current knowledge on Cognitive Behavioural Therapy (CBT), as treatment for depression in coronary artery disease (CAD).

Method: A systematic search was conducted on the PUBMED database for the last ten years, in accordance with the PRISMA guidelines, following PICOS criteria, and applying specific queries in the 'PubMed Advanced Search Builder'.

Results: Twenty-one studies were selected and included in the systematic review, with a total number of 2498 patients enrolled, excluding patient samples analysed multiple times, with results published in different papers. The mean/SD age of the enrolled patients was 56.9±7.7 years (range: 30.3-63.0). The mean/SD number of scales used was 4.2±2.0 (range: 2-9). The psychological intervention included CBT in 8/21 (38.1%) studies, Internet-Delivered CBT (I-CBT) in 8/21 (38.1%), and CBT + Activity in 1/21 (4.8%) Monitor (AM), 1/21 (4.8%) Stress Management CBT-based, 1/21 (4.8%) CBT-WBT Sequential Approach, 1/21 (4.8%) e-IMPACT CBT (CBT delivered via internet o' by phone'), 1/21 (4.8%) Group-CBT. The control groups underwent 'treatment as usual' (TAU) in 5/21 (23.8%) studies, 'online discussion forum' (ODF) in 5/21 (23.8%) studies, 'clinical management' (CM) in 4/21 (19.0%) studies, pharmacological treatment with SSRIs (2/21; 9.5%), 'waiting list condition' (WLC), 'educational support' or 'simple monitoring' in the remaining 4/21 (19.0%) studies; in one study (4.8%), this information was not available.

Conclusions: Efficacy of CBT as a treatment for depressive syndromes in patients with CD is still under discussion, partly due to the heterogeneity of the outcome measures, partly due to methodological issues, such as therapist supervision and allegiance. CBT seems to be irrelevant to biological variables, such as inflammatory markers and heart rate variability and not ever superior to other interventions, in the treatment of depressive symptoms.

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认知行为疗法对冠心病和抑郁症患者的治疗：一项系统综述。

目的：本综述的目的是总结认知行为疗法（CBT）治疗冠状动脉疾病（CAD）抑郁症的最新知识。方法：根据PRISMA指南，遵循PICOS标准，并在“PUBMED高级搜索构建器”中应用特定查询，对PUBMED数据库进行了近十年的系统搜索。结果：21项研究被纳入系统评价，共纳入2498例患者，不包括多次分析的患者样本，结果发表在不同的论文中。入组患者的平均/SD年龄为56.9±7.7岁（范围：30.3-63.0）。所用量表的平均/SD数为4.2±2.0（范围：2-9）。心理干预包括：8/21研究中的CBT（38.1%）、8/21研究中的I-CBT（38.1%）、1/21研究中的CBT +活动（4.8%）、监测（AM）、1/21（4.8%）基于压力管理的CBT、1/21 (4.8%)CBT- wbt顺序方法、1/21 (4.8%)e-IMPACT CBT（通过互联网或“通过电话”提供的CBT）、1/21（4.8%）群体CBT。对照组在5/21（23.8%）的研究中接受“照常治疗”（TAU），在5/21（23.8%）的研究中接受“在线讨论论坛”（ODF），在4/21（19.0%）的研究中接受“临床管理”（CM），用SSRIs进行药物治疗(2/21；9.5%)、“等候名单条件”（WLC）、“教育支持”或“简单监测”（19.0%）；在一项研究（4.8%）中，这一信息不可用。结论：CBT治疗CD患者抑郁综合征的疗效仍在讨论中，部分原因是结果测量的异质性，部分原因是方法学问题，如治疗师的监督和忠诚。CBT似乎与生物变量无关，如炎症标志物和心率变异性，并且在治疗抑郁症状方面并不优于其他干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neuropsychiatry CLINICAL NEUROLOGY-

CiteScore

11.10

自引率

1.60%

发文量