Efeito da intervenção psicológica na ansiedade, depressão e qualidade de vida em pacientes com insuficiência cardíaca: ensaio clínico randomizado

Abstract

Justification: Patients with Heart Failure often present depressive symptoms, anxiety and social and psychological impacts that promote changes in quality of life. Interventions with psychotherapy have been used in different chronic conditions, including cardiovascular, demonstrating improvement in aspects related to mental health. Despite this, there are no studies that have evaluated the effect of psychological intervention, from the point of view of Psychoanalysis, in patients with Heart Failure. Objective: To evaluate the effect of short-term psychological intervention on depressive symptoms, anxiety and quality of life of patients with heart failure, followed up in a specialized clinic. Method: Randomized controlled clinical trial with outpatients with Heart Failure in Niteroi/RJ. Scales were used to evaluate depression (Beck Inventory of Depression), anxiety (Beck Inventory of Anxiety) and quality of life (Minessota Living with Heart Failure Questionnaire), before and after a psychological intervention, from a psychoanalysis point of view, with duration of 12 weekly sessions. Results: The study involved 44 patients, 23 female (52.3%), 65.6±11.3 years and NYHA I functional class (23; 52.3%). 24 were completed, with 11 participants in the intervention group and 13 in the control group. For the outcomes anxiety (p-value = 0.36) and depression (p-value = 0.15) there was no statistically significant difference between the control and intervention groups. However, there was reduction of anxiety and depression symptoms from mild to moderate to mild and minimal in the intervention group. Regarding quality of life, there was a statistical difference between groups (p-value = 0.04), with a large effect (Cohen's d = 0.89). Conclusion: Short-term psychotherapy in outpatients with heart failure showed an impact on the quality of life, particularly on the emotional dimension, but did not show improvement on depression and anxiety, and may be due to the small number of patients. Psychotherapy was safe for patients and should be deployed in specialized clinics for offering a space for listening, reflection and reception on illness and personal issues