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Nonpharmacologic treatments for depression in patients with coronary heart disease.

Publication ,  Journal Article
Lett, HS; Davidson, J; Blumenthal, JA
Published in: Psychosom Med
2005

OBJECTIVES: We review nonpharmacologic treatments for depression in patients with coronary heart disease (CHD), including psychological therapies such as cognitive behavior therapy (CBT) and interpersonal therapy (IPT), aerobic exercise, St. John's wort (SJW), essential fatty acids (EFAs), S-Adenosylmethionine (SAMe), acupuncture, and chromium picolinate (CP). METHOD: Medline searches and reviews of bibliographies were used to identify relevant articles. Each treatment was reviewed with particular attention paid to empirical support, as well as to potential mechanisms of action that might affect not only depression but also CHD endpoints. RESULTS: Nearly all randomized controlled trials (RCTs) of depression treatments have been conducted with non-CHD patients. These studies have provided the most support for psychological treatments, particularly CBT and IPT. Aerobic exercise, SJW, and SAMe also have considerable empirical support in otherwise healthy persons, but SJW may have undesirable side effects for CHD patients. Data for EFAs, CP, and acupuncture are limited; however, the use of aerobic exercise shows considerable promise for cardiac patients. CONCLUSIONS: There are few RCTs of patients with clinical depression and CHD, and those that exist have significant methodological limitations. Nonetheless, there is preliminary evidence that nonpharmacologic treatments are effective for cardiac patients with depression. In terms of reducing depression, the most evidence exists for psychological treatments, particularly CBT and IPT. However, there is little evidence that such treatment would also improve CHD risk factors. Aerobic exercise offers more promise to improve both mental and physical health due to its effect on cardiovascular risk factors and outcomes and thus warrants particular attention in future trials.

Duke Scholars

Published In

Psychosom Med

DOI

EISSN

1534-7796

Publication Date

2005

Volume

67 Suppl 1

Start / End Page

S58 / S62

Location

United States

Related Subject Headings

  • S-Adenosylmethionine
  • Psychotherapy
  • Psychiatry
  • Picolinic Acids
  • Phytotherapy
  • Hypericum
  • Humans
  • Fatty Acids, Essential
  • Exercise
  • Depression
 

Citation

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Lett, H. S., Davidson, J., & Blumenthal, J. A. (2005). Nonpharmacologic treatments for depression in patients with coronary heart disease. Psychosom Med, 67 Suppl 1, S58–S62. https://doi.org/10.1097/01.psy.0000163453.24417.97
Lett, Heather S., Jonathan Davidson, and James A. Blumenthal. “Nonpharmacologic treatments for depression in patients with coronary heart disease.Psychosom Med 67 Suppl 1 (2005): S58–62. https://doi.org/10.1097/01.psy.0000163453.24417.97.
Lett HS, Davidson J, Blumenthal JA. Nonpharmacologic treatments for depression in patients with coronary heart disease. Psychosom Med. 2005;67 Suppl 1:S58–62.
Lett, Heather S., et al. “Nonpharmacologic treatments for depression in patients with coronary heart disease.Psychosom Med, vol. 67 Suppl 1, 2005, pp. S58–62. Pubmed, doi:10.1097/01.psy.0000163453.24417.97.
Lett HS, Davidson J, Blumenthal JA. Nonpharmacologic treatments for depression in patients with coronary heart disease. Psychosom Med. 2005;67 Suppl 1:S58–S62.

Published In

Psychosom Med

DOI

EISSN

1534-7796

Publication Date

2005

Volume

67 Suppl 1

Start / End Page

S58 / S62

Location

United States

Related Subject Headings

  • S-Adenosylmethionine
  • Psychotherapy
  • Psychiatry
  • Picolinic Acids
  • Phytotherapy
  • Hypericum
  • Humans
  • Fatty Acids, Essential
  • Exercise
  • Depression