Anxiety, depression treatment linked with improved outcomes in cardiovascular disease
Patients who had been hospitalized and had both cardiovascular disease and a mental health condition were 75% less likely to be readmitted if they received psychotherapy and medication for their anxiety or depression.
Mental health treatment for anxiety or depression is associated with reduced hospitalizations and ED visits among patients with cardiovascular disease, according to results of a retrospective cohort study.
To examine the association between psychotherapy or antidepressant medication and outcomes among patients with coronary artery disease or heart failure, researchers assessed data from 1,563 patients with a mean age of 50.1 years (68% female, 80.9% White). All included patients had been hospitalized for heart disease diagnoses, had claims for mental health treatment, and were enrolled in Ohio's Medicaid program for six months prior to admission. Findings were published by the Journal of the American Heart Association on March 20.
A total of 92.2% of patients had anxiety and 55.5% had depression. Among all patients, 23.2% received psychotherapy and medication, 14.8% received psychotherapy alone, 29.2% received antidepressants alone, and 33% received no treatment for their mental health condition.
Patients who received any mental health treatment were significantly less likely to use additional health care services or die than those who received no mental health treatment. Specifically, patients who received psychotherapy and antidepressant prescriptions for anxiety or depression were 75% less likely to be readmitted to the hospital (P<0.001). There was a 49% reduction in readmissions for patients who received psychotherapy alone and a 58% reduction for medication alone. Patients who received both forms of mental health treatment were 74% less likely to visit the ED (P<0.001). Psychotherapy plus medical therapy also led to a significant 66% reduction in all-cause mortality.
To the authors' knowledge, the study is the first to show that mental health treatment may be associated with reduced risk for relevant outcomes in this patient population. "These findings indicate that mental health interventions are essential to reducing hospitalizations and ED visits in patients with [heart failure] or coronary disease and concomitant depression or anxiety," they wrote.
The study only included Medicaid beneficiaries in Ohio, so the results may not be generalizable. Researchers were also unable to determine the type of psychotherapy patients received.
Overall, "these findings motivate further studies investigating mental health interventions in patients with [cardiovascular disease]. Studies investigating the mechanistic basis for the benefits of these interventions will guide the design of new treatment strategies that can alleviate both the personal health and financial burden of [cardiovascular disease] and mental illness," the authors concluded.