IMPACT OF CARDIAC REHABILITATION PROGRAM IN ANXIETY AND DEPRESSION. A CASE-CONTROL STUDY

Abstract

Objective: The association of depression with increased mortality is widely demonstrated in patients with cardiovascular disease (CVD). Depression and anxiety are common in this group and may adversely affect cardiovascular outcomes. The Hospital Anxiety and Depression Scale (HADS) englobes two scales (HASD-D for depression and HADS-A for anxiety) and is a 14-item tool to measure anxiety and depression symptoms in medical patients, which was shown to be an excellent tool when assessing the psychological well-being of patients undergoing cardiac rehabilitation. This study aims to evaluate whether entry into a rehabilitation programme is associated with a lower HADS score. Design and method: Single center, cross-sectional case-control study comparing a screening anxiety and depression score – Hospital Anxiety and Depression Score (HADS) - in patients submitted to a Cardiac Rehabilitation (CR) program with a matched control group. Each patient in the study group was matched by sex, age and primary pathology to an individual in the control group. The selection bias was reduced by the selection of control patients in our institution previously to the implementation of the CR program. Descriptive analysis was performed using means and standard deviation (SD), medians and Interquartile range (IQR) for continuous data, and frequencies and percentages for qualitative variables. HADS Score was compared between groups using Independent-Samples T Test in SPSS® software. Results: We studied a total 36 patients (18 CR patients and 18 matched controls), 72.2% were men, and the mean age of patients was 55.2 years. Upon comparison, the patients in the CR group had a statistically significantly lower HADS Score compared with matched non-CR patients (2.7 vs 3.5, p<.05) (Table 1). Conclusions: This study suggests that inclusion into a cardiac rehabilitation programme helps to reduce the HADS scores of post-MI patients.