Talk therapy help depression after heart surgery

Cognitive behaviour therapy, and to a lesser extent supportive stress management, help depressed patients who have had heart bypass surgery. Antidepressants, on the other hand, appear to have little effect in such patients. One fifth of patients suffer a major bout of depression following bypass heart surgery and a similar number develop milder forms of depression. Researchers from America studied 123 depressed bypass patients to test the efficacy of 2 non-drug interventions for depression after coronary artery bypass surgery compared with usual care. They randomised 41 patients to receive cognitive behaviour therapy, 42 for supportive stress management, and 40 to receive usual care. About half the patients in each group were taking antidepressants. During follow-up after 3 months it was found that 71 percent of patients in the cognitive behaviour therapy group and 57 percent in the supportive stress management group saw their depression lift, compared to just 33 percent of patients in the usual care group. The differences narrowed at the 6-month follow-up but differed again at 9 months (73 percent for the cognitive behaviour therapy group, 57 percent for the supportive stress management group and 35 percent for the usual care group). Cognitive behaviour therapy was superior to usual care on most secondary psychological outcomes, including anxiety, hopelessness, perceived stress and the mental (but not the physical) component of health-related quality of life. Supportive stress management was superior to usual care only on some of these measures. In this study, antidepressant medicines did not influence the outcome of depression.

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