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Does psychological treatment of major depression reduce cardiac risk biomarkers? An exploratory randomized controlled trial

BACKGROUND: Depression is associated with an increased risk for cardiovascular disease (CVD). Biological cardiac risk factors are already elevated in depressed patients without existing CVD. The purpose of this exploratory trial was to examine whether treating Major Depression (MD) with cognitive be...

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Autores principales: Euteneuer, Frank, Neuert, Marie, Salzmann, Stefan, Fischer, Susanne, Ehlert, Ulrike, Rief, Winfried
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277774/
https://www.ncbi.nlm.nih.gov/pubmed/35232509
http://dx.doi.org/10.1017/S0033291722000447
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author Euteneuer, Frank
Neuert, Marie
Salzmann, Stefan
Fischer, Susanne
Ehlert, Ulrike
Rief, Winfried
author_facet Euteneuer, Frank
Neuert, Marie
Salzmann, Stefan
Fischer, Susanne
Ehlert, Ulrike
Rief, Winfried
author_sort Euteneuer, Frank
collection PubMed
description BACKGROUND: Depression is associated with an increased risk for cardiovascular disease (CVD). Biological cardiac risk factors are already elevated in depressed patients without existing CVD. The purpose of this exploratory trial was to examine whether treating Major Depression (MD) with cognitive behavioral therapy (CBT) is associated with improvements in cardiac risk biomarkers and whether depressive symptom severity at baseline moderates treatment effects. METHODS: Eighty antidepressant-free patients with MD were randomly assigned to CBT or waiting list (WL). Biological outcomes included long-term recordings (24-h, daytime, nighttime) of heart rate, heart rate variability (HRV), and blood pressure, as well as inflammatory markers such as C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-α. A sample of 40 age- and sex-matched non-clinical controls was also involved to verify biological alterations in MD at study entry. RESULTS: Compared to WL, CBT was associated with a significant increase in overall HRV, as indexed by the 24-h and daytime HRV triangular index, as well as trend improvements in 24-h low-frequency HRV and daytime systolic blood pressure. Self-rated depressive symptom severity moderated (or tended to moderate) improvements in CBT for 24-h and daytime heart rate and several indices of HRV (especially daytime measures). Inflammatory treatment effects were not observed. CONCLUSIONS: CBT increased overall HRV in patients with MD. Initially more depressed patients showed the most pronounced cardiovascular improvements through CBT. These exploratory findings may provide new insights into the biological effects of psychological treatment against depression and must be confirmed through future research.
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spelling pubmed-102777742023-06-20 Does psychological treatment of major depression reduce cardiac risk biomarkers? An exploratory randomized controlled trial Euteneuer, Frank Neuert, Marie Salzmann, Stefan Fischer, Susanne Ehlert, Ulrike Rief, Winfried Psychol Med Original Article BACKGROUND: Depression is associated with an increased risk for cardiovascular disease (CVD). Biological cardiac risk factors are already elevated in depressed patients without existing CVD. The purpose of this exploratory trial was to examine whether treating Major Depression (MD) with cognitive behavioral therapy (CBT) is associated with improvements in cardiac risk biomarkers and whether depressive symptom severity at baseline moderates treatment effects. METHODS: Eighty antidepressant-free patients with MD were randomly assigned to CBT or waiting list (WL). Biological outcomes included long-term recordings (24-h, daytime, nighttime) of heart rate, heart rate variability (HRV), and blood pressure, as well as inflammatory markers such as C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-α. A sample of 40 age- and sex-matched non-clinical controls was also involved to verify biological alterations in MD at study entry. RESULTS: Compared to WL, CBT was associated with a significant increase in overall HRV, as indexed by the 24-h and daytime HRV triangular index, as well as trend improvements in 24-h low-frequency HRV and daytime systolic blood pressure. Self-rated depressive symptom severity moderated (or tended to moderate) improvements in CBT for 24-h and daytime heart rate and several indices of HRV (especially daytime measures). Inflammatory treatment effects were not observed. CONCLUSIONS: CBT increased overall HRV in patients with MD. Initially more depressed patients showed the most pronounced cardiovascular improvements through CBT. These exploratory findings may provide new insights into the biological effects of psychological treatment against depression and must be confirmed through future research. Cambridge University Press 2023-06 2022-03-02 /pmc/articles/PMC10277774/ /pubmed/35232509 http://dx.doi.org/10.1017/S0033291722000447 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Original Article
Euteneuer, Frank
Neuert, Marie
Salzmann, Stefan
Fischer, Susanne
Ehlert, Ulrike
Rief, Winfried
Does psychological treatment of major depression reduce cardiac risk biomarkers? An exploratory randomized controlled trial
title Does psychological treatment of major depression reduce cardiac risk biomarkers? An exploratory randomized controlled trial
title_full Does psychological treatment of major depression reduce cardiac risk biomarkers? An exploratory randomized controlled trial
title_fullStr Does psychological treatment of major depression reduce cardiac risk biomarkers? An exploratory randomized controlled trial
title_full_unstemmed Does psychological treatment of major depression reduce cardiac risk biomarkers? An exploratory randomized controlled trial
title_short Does psychological treatment of major depression reduce cardiac risk biomarkers? An exploratory randomized controlled trial
title_sort does psychological treatment of major depression reduce cardiac risk biomarkers? an exploratory randomized controlled trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277774/
https://www.ncbi.nlm.nih.gov/pubmed/35232509
http://dx.doi.org/10.1017/S0033291722000447
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