MedWire News: Heart failure patients who suffer from depression may benefit from exercise combined with psychological therapy to improve their physical function, reduce their depressive symptoms and enhance quality of life, say US researchers.

Dr Rebecca Gary, from Emory University in Atlanta, Georgia, and colleagues studied 74 patients with heart failure, aged an average of 66 years, who had also been diagnosed with depression - a common problem among such patients.

The participants were divided into four groups to receive a 3-month, home-based programme of exercise and psychological counselling, psychological counselling alone, exercise alone, or no such interventions.

The exercise component of the programme included low-to-moderate intensity walking three times a week for at least 30 minutes. Participants assigned to exercise received heart rate monitors and were taught how to self-monitor their exertion levels, and when to stop exercising.

Psychological counselling, called cognitive behavioural therapy, was conducted in one-to-one sessions in the patients' homes by psychiatric nurse specialists. These sessions were designed to encourage patients to think positively and 'reformat' their beliefs about their illness and activity limitations.

At the end of the 3-month study, patients assigned to exercise plus psychological counselling performed significantly better in exercise tests than patients in any of the other groups.

Furthermore, patients in the combined exercise and psychological counselling group were significantly less depressed by the end of the study period than most of the other patients.

Interestingly, although patients in the counselling only group also experienced a reduction in their depression symptoms, they perceived their quality of life to be worse than that perceived by patients in the combined and exercise only groups.

"By combining exercise with psychological counselling, these depressed [heart failure] patients do better in all parameters compared to the other groups," said Dr Gary.

She concluded that, for depressed heart failure patients, exercise combined with cognitive behavioural therapy "may be the best method for improving their depression, symptom severity, and quality of life".

The findings were presented at the American Heart Association's Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Conference in Baltimore, Maryland, USA.

Meeting website