Heart failure affects over 64 million adults globally. Around 50% of people with heart failure have symptoms of depression. Studies show that patients with heart failure and depression have lower cardiac function, more emergency department visits and hospital admissions, higher caregiver burden, and a lower health-related quality of life than those with heart failure who do not have depression.
In the current study, researchers compared the efficacy of behavioral activation psychotherapy (BAP) and antidepressant medication in patients with heart failure and depression. BAP involves working with a therapist to identify and implement more pleasurable activities in daily life. Studies show that it has a similar effectiveness to cognitive behavioral therapy (CBT) in treating depression. The researchers noted, however, that it may be more suitable for patients with heart failure as, unlike CBT, it doesn't delve into 'complex cognitive domains'.
For the study, the researchers recruited 416 patients with heart failure and depression who were an average of 60 years old. Patients were randomized into two groups, receiving either BAP or antidepressant medication.
Ultimately, they found that both groups experienced an almost 50% reduction in depressive symptoms at 3, 6, and 12 months. However, psychotherapy patients had fewer emergency department visits and days of hospitalization alongside slightly improved physical health-related quality of life at six months compared to those on medication.
First author of the study, Waguih W. Ishak, MD, vice chair of Education and Research in the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai Medical Center, said, in a press release:
"The most important finding here is that patients experiencing depression have a choice in terms of their treatment between therapy or medications. Patients who prefer not to be on medication can do behavioral activation therapy with similar results."
Sources: Science Daily, JAMA Network Open
