What does this research mean for the field?

Reductions in general anxiety and heart-related anxiety during psychocardiological rehabilitation improve work-related outcomes and quality of life. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

What question did this study set out to answer?

This research aims to determine which psychological improvements correlate with better functional outcomes in patients undergoing psychocardiological rehabilitation.

January 10, 2026Scientific Reports0 citationsOpen Access

Improvement of anxious but not depressive symptoms is associated with functional outcomes of psychocardiological rehabilitation

LPLilia PapstCharité - Universitätsmedizin Berlin CSChristoph SchmitzCharité - Universitätsmedizin Berlin ELEike LangheimDeutsche Rentenversicherung Bund

Key Result

Reductions in general anxiety and heart-related anxiety during psychocardiological rehabilitation improved work-related outcomes and quality of life.

Key Points

This research aims to determine which psychological improvements correlate with better functional outcomes in patients undergoing psychocardiological rehabilitation.
243 patients assessed at admission and discharge
Symptoms measured using HADS and CAQ
Functional outcomes evaluated with sociomedical evaluations and MINI-ICF-APP-S
Quality of life assessed using SF-12
Regression analyses conducted to explore associations
Reductions in general anxiety and heart-related anxiety linked to fewer work-related impairments (p = 0.03)
Higher mental quality of life associated with reductions in anxiety (p ≤ 0.001)
Higher physical quality of life linked to reduced heart-related anxiety (p ≤ 0.001)
Improvements in depressive symptoms did not correlate with functional outcomes

Structured PICO

Does improvement in anxious and depressive symptoms reduce work-related impairments and improve quality of life in patients undergoing psychocardiological rehabilitation?

Population

243 inpatients (age 18-70, mean age 54.8, 51.0% female) with comorbid somatic cardiac diagnoses (48.2% ischaemic heart disease, 32.5% conduction/arrhythmic disorders) and psychiatric diagnoses (depression, anxiety, or both) undergoing psychocardiological rehabilitation in Germany.

Intervention

Psychocardiological rehabilitation (standard duration 5 weeks, including exercise therapy, cognitive-behavioral psychotherapy, relaxation techniques, and dietary consultation)

Outcome

Subjective and objective capacity to pursue work (assessed by MINI-ICF-APP-S and sociomedical evaluation) and quality of life (assessed by SF-12) at dischargepatient reported

In patients undergoing psychocardiological rehabilitation, improvements in anxiety, but not depression, are associated with better functional outcomes and quality of life, highlighting the importance of targeting anxiety in cardiac rehabilitation.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Cardiovascular and mental health conditions are closely linked, and integrative treatments increasingly target both. However, it remains unclear which psychological improvements most strongly influence functional outcomes, such as work ability and quality of life. We hypothesized that reductions in depressive symptoms, general anxiety, and heart-related anxiety would be associated with better work ability, fewer work-related impairments, and improved quality of life. We assessed 243 patients undergoing psychocardiological rehabilitation at admission and discharge. Depressive and anxiety symptoms were measured using the Hospital Anxiety and Depression Scale (HADS), heart-related anxiety by Cardiac Anxiety Questionnaire (CAQ), work-related impairments by sociomedical evaluation and the Mini-ICF-APP Social Functioning Scale (MINI-ICF-APP-S), and quality of life with the Short Form-12 health survey (SF-12). Regression analyses revealed that reductions in general anxiety (HADS-A) and heart-related anxiety (CAQ) were linked to fewer work-related impairments ( p = 0.03) and higher mental quality of life ( p ≤ 0.001 and p ≤ 0.01, respectively). Reduced heart-related anxiety was also associated with higher physical quality of life ( p ≤ 0.001). In contrast, higher baseline depressive symptoms (HADS-D) increased the odds of limited work ability (OR = 1.78, p = 0.01), while improvements in depression were not associated with functional outcomes. These results suggest that depressive and anxiety symptoms are similarly responsive to psychocardiological rehabilitation, but only the latter are associated with improved functional outcomes.

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