BRAVEHEART: Group cognitive behaviour therapy for cardiac depression

  • Alyna Turner, Centre for Brain and Mental Health Research, University of Newcastle, Australia
  • Mr John Hambridge, Liaison Psychiatry, John Hunter Hospital, Hunter New England Health Service, NSW, Australia
  • A/Prof Amanda Baker, Centre for Brain and Mental Health Research, University of Newcastle, Australia
  • Dr Frances Kay-Lambkin, National Drug and Alcohol Research Centre, University of NSW, Australia
  • Dr Jenny Bowman, School of Psychology, the University of Newcastle, Australia
  • Dr Stephanie Oak, Liaison Psychiatry, John Hunter Hospital, Hunter New England Health Service, NSW, Australia

    • AIMS Among people with existing heart disease, there is a need for routine screening to identify those with symptoms of depression and efficacious interventions on offer when required. In a general medical hospital with limited mental health resources, a clinical need arose for an effective treatment for depression in cardiac rehabilitation patients. The aim of the study was to develop and evaluate a specialized group 6-week group cognitive behaviour therapy (CBT) intervention (BraveHeart) for treatment of depression in people with cardiac disease.
    STUDY DESIGN Results will be presented for a pilot case series study and a follow-up randomised controlled trial (RCT) comparing BraveHeart to a brief intervention (BI).
    PARTICIPANTS BraveHeart was piloted in 39 cardiac rehabilitation patients over 6 groups. 57 cardiac rehabilitation and community-dwelling cardiac patients participated in the RCT.
    OUTCOME MEASURES Severity of depression and anxiety symptoms as measured by the Beck Depression Inventory-II and Hospital Anxiety and Depression Scales scores.
    RESULTS A significant reduction in levels of depression and anxiety symptoms occurred in 30 patients that completed the BraveHeart pilot program. For the RCT, using 2-month follow-up data a significant reduction in depression and anxiety symptoms again occurred, with no difference between BraveHeart and BI conditions.
    CONCLUSIONS Depression leads to worse outcomes among cardiac patients, and development of efficacious psychological treatments is indicated. While a group treatment results in a significant improvement in depression and anxiety symptoms, a BI has a similar impact and may play an important role in a treatment approaches.