Phase 2 cardiac rehab without mental health resources improved anxiety, depression, and quality of life, but 20.1% had persistent symptoms, mainly younger with prior MH issues.
Does a Phase 2 Cardiac Rehabilitation Program without dedicated mental health resources improve depression, anxiety, and quality of life in post-myocardial infarction patients?
A Phase 2 cardiac rehabilitation program without dedicated mental health resources significantly improves mental well-being after MI, though a younger, higher-risk subset may require targeted interventions.
Absolute Event Rate: 0% vs 0%
Abstract Background Anxiety and depression are common after a myocardial infarction (MI), so psychological and psychiatric mental health (MH) interventions are recommended during Cardiac Rehabilitation Programs (CRP). However, many CRP lack specific resources for MH interventions. Purpose To evaluate anxiety and depression symptoms and quality of life in MI patients followed in a CRP without dedicated MH resources. Methods We prospectively included 164 MI patients in our CRP, which lacks dedicated MH resources. The Patient Health Questionnaire 2-item (PHQ-2) and Generalized Anxiety Disorder 2-item (GAD-2) questionnaires were used for depression and anxiety screening (altered if ≥3 points), and the 36-Item Short Form Survey Instrument (SF-36) was used to analyze four MH components and Mental Component Summary (MCS, altered if 40 points). These assessments were conducted at the beginning and after Phase 2 of the CRP. We analyzed the proportion of patients with altered PHQ-2, GAD-2 and SF-36-MCS scores before and after CRP, as well as the predictors of significant depression and/or anxiety symptoms at the end of CRP. Results The mean age was 61.35±10.76 years and most patients were male (86.6%). A significant improvement was observed in SF-36 mental components (from +5.94±27.98 to +8.31±25 points, p0.001) and SF-36-MCS (+1.85±10.23 points, p=0.02). Additionally, PHQ-2 and GAD-2 scores significantly diminished from a median of 1 0, 2 to 0 0, 2 points and from 2 0, 3 to 1 0, 2 points (both p0.001), respectively, indicating a reduction in depressive and anxiety symptoms. However, 33 (20.1%) patients showed a positive screening for depression and/or anxiety at the end of the program. These patients were younger (56.6±8.05 vs. 62.55±11.05 years, p=0.004), had a higher prevalence of prior depression and anxiety before MI (18.2% vs. 5.3% and 24.2% vs. 10.7%, respectively), and showed significantly worse initial scores in SF-36 mental components, PHQ-2, and GAD-2 (p0.001). Conclusions A Phase 2 CRP without dedicated MH resources can achieve significant improvements in mental well-being after MI. However, one-fifth of the population had substantial depression and/or anxiety symptoms at the end of the program. This subset, characterized by younger age, a higher prevalence of pre-MI anxiety and depression, and worse initial MH scores, may benefit from targeted MH interventions during CRP.Depression, anxiety and QoL during CRP. Mental health/QoL before and after CRP.
Garces et al. (Sat,) reported a other. Phase 2 cardiac rehab without mental health resources improved anxiety, depression, and quality of life, but 20.1% had persistent symptoms, mainly younger with prior MH issues.