Issn Print: 0883-9212

Publication Date: 2000/09/01


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DOES DEPRESSION IMPEDE EXERCISE-FOCUSED REHABILITATION?

David Paul; Wolfgang Linden; Jelena Maric; Quincy R. Young

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Excerpt

503 adults (349 male, 157 female) completed 16 weeks of post-event cardiac rehabilitation consisting of exercise, nutritional counseling, and general education about cardiovascular disease. No physiological interventions were included. On beginning the program, and again upon finishing, each participant completed the Healthy Heart Psychosocial Screening Questionnaire, a brief self-report measure assessing depression, hopelessness, hostility, perceived social support, cardiac-related physical symptoms, and functional physical impairment.
To examine the impact of depression on participant's capacity to benefit from rehabilitation, the sample was divided according to severity of participants' depressive symptomatology on entering the program. Individuals reporting initially high levels of depression (n = 154) showed a large reduction [F = 93.05, P = .000; d = 0.82] in depressive symptoms upon completing rehabilitation. No sex differences in the amount of change in depressive symptomatology were found, even though women reported significantly higher levels of depression than men both before [t = 3.15, P = .002] and after [t = 2.39, P = .017] rehabilitation. Changes in the remaining variables did not differ significantly between depressed and non-depressed participants. These results provide supportive evidence that depressed cardiac patients stand to gain more, and not less from exercise-focused rehabilitation than their counterparts who report few or no such symptoms. As a consequence, all staff should do their utmost to encourage depressed patients' participation in cardiac rehab even if this requires extra recruiting effort.
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