Despite advancements in medical care, the quality of life for adults and adolescents affected by congenital heart disease often leads to depression. Psychotherapy, cognitive behavioral therapy, and other talking therapies may provide effective treatment for depression in this population. It was important for the study to assess the effects of such treatments in this population.
The objective of the review was to evaluate the effects of psychological interventions in reducing depression in adolescents and adults with congenital heart disease. Such interventions include cognitive behavioral therapy, psychotherapy, or ‘talking/counseling’ therapy for depression. The research was updated from the 2013 Cochrane Review by searching CENTRAL, four other databases, and the Conference Proceedings Citation Index until 7 March 2023, with no language restrictions applied.
The selection criteria focused on randomized controlled trials (RCTs) that compared psychological interventions to no intervention in the congenital heart disease population, aged 10 years and older, with depression. Two review authors independently screened titles and abstracts and independently assessed full-text reports for inclusion. The primary outcome was a change in depression, with secondary outcomes including treatment acceptability, quality of life, hospital readmissions, non-fatal cardiovascular events, cardiovascular behavioral risk factors, health economics, cardiovascular mortality, and all-cause mortality.
Three new RCTs were identified, involving 480 participants who were adults with congenital heart disease. The interventions varied in length and follow-up, with depression assessed post-intervention and at follow-up. The risk of bias assessment identified an overall low risk of bias for the main outcome of depression. It was found that psychological interventions may reduce depression more than usual care at both three-month and 12-month follow-ups, although there was insufficient evidence to draw conclusions about the impact of psychological interventions on quality of life.
In conclusion, psychological interventions may reduce depression in adults with congenital heart disease compared to usual care. However, the certainty of the evidence is low. Further research is needed to establish the role of psychological interventions in this population, defining the optimal duration, method of administration, and number of sessions required to obtain the greatest benefit.
Original Article DOI: 10.1002/14651858.CD004372.pub3
Original title: Psychological interventions for depression in adolescent and adult congenital heart disease
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