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Review: psychological and pharmacological treatments reduce depression symptoms in adults with coronary artery disease, but have no effect on mortality or cardiac events

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Question

Question

What are the effects of psychological and pharmacological interventions for depression in coronary artery disease (CAD) patients with comorbid depression?

Outcomes

Primary outcomes were depression symptoms, depression remission, all-cause and CAD-related morality and non-fatal cardiac events or surgery.

Methods

Design

Systematic review and meta-analysis.

Data sources

Searches were carried out on 15 July 2009 in 10 electronic databases (CENTRAL, DARE, HTA and EED on The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, ISRCTN Register and CardioSource Registry). Reference lists of included randomised controlled trials (RCTs) were also examined for relevant trials. Study authors were contacted for recommendations of other relevant published and unpublished RCTs.

Study selection and analysis

RCTs of psychological and/or pharmacological interventions for depression in adults with CAD and comorbid depression were included. Psychological interventions included cognitive behavioural therapy (CBT), ;psychodynamic psychotherapy, interpersonal psychotherapy, non-directive or supportive therapy and counselling. Eligible comparators included usual treatment and different psychological treatments.

Main results

Sixteen RCTs (reported in 42 publications) met inclusion criteria; seven focused on psychological interventions, eight focused on pharmacological interventions and one examined both psychological and pharmacological treatments. Psychological interventions versus usual care: CBT improved depression symptoms compared with usual care in the short and long-term …

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