Table 5.
Meta-analyses until 2018 on psychological intervention in cardiovascular disease.
| Study-Design | Number of Studies |
Population | Results: (+) = Effective; (0) = Effectivity Not Proven (SMD, MD, OR, log-OR, d, ARR, r (95% CI)) |
Annotations |
|---|---|---|---|---|
| [215] | ||||
| RCTs | 12 | N = 2.202 CHD, ACS/MI |
Depression SMD −0.35 (−0.52; −0.17) (+) (depressive symptoms reduced) Anxiety SMD −0.34 (−0.65; −0.03) (+) (anxiety reduced) QoL mental MD 3.62 (0.2; 7.02) (+) (mental quality of life improved) QoL somatic MD 2.59 (−0.41; 5.60) (0) CV events OR 0.80 (0.3; 1.93) (0) treatment satisfaction SMD 0.11 (−0.29; 0.51) (0) |
Studies 2003–2014. Patients with higher depressive symptoms and anxiety. CBT only +/− antidepressive medication. Low study-quality, control and intervention group inhomogeneous |
| [216] | ||||
| RCTs | 35 | N = 10.703 CAD, AMI, PCI, CABG, |
Depression SMD −0.27 (−0.39; −0.15) (+) (depressive symptoms reduced) Anxiety SMD −0.24 (−0.38;−0.09) (+) (anxiety reduced) Disstress SMD −0.56 (−0.88; −0.24) (+) (disstress reduced) Cardiac mortality RR 0.79 (0.63; 0.98) (+) (Cardiac mortality reduced) Total mortality RR 0.90 (0.77; 1.05) (0) PCI/CABG RR 0.94 (0.81; 1.11) (0) Non-fatal MI RR 0.82 (0.64; 1.05) (0) |
Studies 1974–2016. Low study-quality, control and intervention group inhomogeneous |
| [217] (results on “mental health treatments“ only) | ||||
| RCTs | 18 | N = 9.819 CHD, CHF |
Depression d 0.297 (0.16; 0.43) (+) (depressive symptoms reduced) Total mortality ARR −0.001 (−0.016; 0.15) (0) Cardiovascular mortality and events ARR 0.029 (0.007; 0.51) (+) (Cardiovascular mortality and events reduced) |
Studies 1996–2011 Psychological intervention without antidepressive medication. Low study-quality, control and intervention group inhomogenous |
| [218] | ||||
| RCTs | 51 | N = n. a. CHD |
Depression SMD −0.23 (−0.35; −0.11) (+) (depressive symptoms reduced) Anxiety SMD −0.15 (−0.29; −0.04) (+) (anxiety reduced) Total mortality log-OR −0.14 (−0.47; 0.15) (0) Cardiac Mortality log-OR −0.16 (−0.44; 0.07) (0) Non-fatal MI log-OR −0.35 (−0.65; −0.10) (+) (non-fatal MI reduced) |
Studies 1974–2006 Control and intervention group inhomogeneous |
| [214] | ||||
| RCTs | 43 | N = 12.023 CHD, MI, PCI, CABG |
Depression (Int vs. Co) r −0.30 vs. −0.21 (0) Depression men (Int vs. Co) r −0.28 vs. −0.17 (+) (Depression in men reduced) Depression women (Int vs. Co) r −0.28 vs. −0.23 (0) Anxiety (Int vs. Co) r −0.17 vs. −0.11 (0) Anxiety in men (Int vs. Co) r −0.11 vs. −0.03 (0) Anxiety in women (Int vs. Co) r −0.18 vs. −0.25 (0) Disstress (Int vs. Co) r −0.36 vs. −0.20 (0) Disstress in men (Int vs. Co) r −0.76 vs. −0.53 (0) Disstress women (Int vs. Co) r −0.27 vs. −0.10 (+) (Disstress in women reduced) Social support (Int vs. Co) r −0.28 vs. −0.2 (+) (social support improved) Social support men (Int vs. Co) r −0.29 vs. −0.14(+) (social suppoprt in men improved) Social support women (Int vs. Co) r −0.44 vs. −0.14 (+) (social support in women improved) QoL (Int vs. Co) r −0.21 vs. −0.13 (+) (quality of life improved) SBD (int vs. Co) r −0.03 vs. 0.08 (0) DBD (Int vs. Co) r −0.09 vs. 0.03 (0) Total mortality (<2 years) OR 0.72 (0.56; 0.94) (+) (total mortality improved until 2 years) Total mortality (>2 years) OR 0.89 (0.80; 1.01) (0) Total mortality men OR 0.73 (0.57; 1.00) (+) (total mortality in men reduced) Total mortality in women OR 1.01 (0.87; 1.72) (0) |
Studies 1975–2005 Control and intervention group inhomogeneous |
Abbreviations: RCT: Randomized Controlled Trial; CBT: Cognitive Behavioral Therapy; CHD: (stable) Coronary Heart Disease; MI/ACS: Myocardial infarction/Acute Coronary Syndrome; PCI: Percutaneous Coronary Intervention; CABG: Coronary Artery Bypass Graft Surgery; CHF: Congestive Heart Failure; Int: Intervention-group; Co: Control-group; SMD: Standardized Mean Difference; MD: Mean Difference; OR: Odds Ratio; log-OR: logarithmic Odds Ratio; ARR: Absolute Risk Reduction; r: Correlation coefficient for change (converted from Cohen’s d); d: Cohen’s d; (significat results in bold).