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Anhedonia is associated with poor health status and more somatic and cognitive symptoms in patients with coronary artery disease.

Pelle AJ, Pedersen SS, Erdman RA, Kazemier M, Spiering M, van Domburg RT, Denollet J - Qual Life Res (2010)

Bottom Line: Adjusting for clinical and demographic factors, health status improved significantly during the follow-up (F(1,357) = 10.84, P = .001).Anhedonic patients reported poorer health status compared with non-anhedonic patients, with anhedonia exerting a stable effect over time (F(1,358) = 34.80, P < .001).Anhedonics experienced more benefits in terms of somatic and cognitive symptoms over time (F(1,358) = 13.00, P < .001).

View Article: PubMed Central - PubMed

Affiliation: Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.

ABSTRACT

Purpose: The effectiveness of cardiac rehabilitation (CR) in patients with coronary artery disease (CAD) is moderated by negative emotions and clinical factors, but no studies evaluated the role of positive emotions. This study examined whether anhedonia (i.e. the lack of positive affect) moderated the effectiveness of CR on health status and somatic and cognitive symptoms.

Methods: CAD patients (n = 368) filled out the Hospital Anxiety and Depression Scale (HADS) to assess anhedonia at the start of CR, and the Short-Form Health Survey (SF-36) and the Health Complaints Scale (HCS) at the start of CR and at 3 months to assess health status and somatic and cognitive symptoms, respectively.

Results: Adjusting for clinical and demographic factors, health status improved significantly during the follow-up (F(1,357) = 10.84, P = .001). Anhedonic patients reported poorer health status compared with non-anhedonic patients, with anhedonia exerting a stable effect over time (F(1,358) = 34.80, P < .001). Somatic and cognitive symptoms decreased over time (F(1,358) = 3.85, P = .05). Anhedonics experienced more benefits in terms of somatic and cognitive symptoms over time (F(1,358) = 13.00, P < .001).

Conclusion: Anhedonic patients reported poorer health status and higher levels of somatic and cognitive symptoms prior to and after CR. Somatic and cognitive symptoms differed as a function of anhedonia over time, but health status did not. Anhedonia might provide a new avenue for secondary prevention in CAD.

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Related in: MedlinePlus

Flow chart of patient selection
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Fig1: Flow chart of patient selection

Mentions: Consecutive patients with CAD (n = 368; response rate = 71.2%) referred to CAPRI (cardiac rehabilitation program at the Rotterdam Organization for Cardiac Rehabilitation, Rotterdam, The Netherlands) between March 2004 and October 2005, participating in the identification of subgroups of HEART patients that may not benefit optimally from CArdiac Rehabilitation (HEARTCARE) study, comprised the sample for the current study. Patients diagnosed with chronic heart failure by their treating cardiologist (due to participation in another study within the institution) and those with insufficient knowledge of the Dutch language to be able to complete questionnaires were excluded from participation. A flow-chart of the patient selection is provided in Fig. 1. Patients were asked to complete a set of psychological questionnaires at baseline and at 3-month follow-up (i.e. prior to and after completion of the rehabilitation program). The present study was set up as a between-subjects design, and not as a randomized controlled trial, given that CR has been shown to decrease mortality. Hence, it would be unethical to withhold CR from patients [6].Fig. 1


Anhedonia is associated with poor health status and more somatic and cognitive symptoms in patients with coronary artery disease.

Pelle AJ, Pedersen SS, Erdman RA, Kazemier M, Spiering M, van Domburg RT, Denollet J - Qual Life Res (2010)

Flow chart of patient selection
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3102190&req=5

Fig1: Flow chart of patient selection
Mentions: Consecutive patients with CAD (n = 368; response rate = 71.2%) referred to CAPRI (cardiac rehabilitation program at the Rotterdam Organization for Cardiac Rehabilitation, Rotterdam, The Netherlands) between March 2004 and October 2005, participating in the identification of subgroups of HEART patients that may not benefit optimally from CArdiac Rehabilitation (HEARTCARE) study, comprised the sample for the current study. Patients diagnosed with chronic heart failure by their treating cardiologist (due to participation in another study within the institution) and those with insufficient knowledge of the Dutch language to be able to complete questionnaires were excluded from participation. A flow-chart of the patient selection is provided in Fig. 1. Patients were asked to complete a set of psychological questionnaires at baseline and at 3-month follow-up (i.e. prior to and after completion of the rehabilitation program). The present study was set up as a between-subjects design, and not as a randomized controlled trial, given that CR has been shown to decrease mortality. Hence, it would be unethical to withhold CR from patients [6].Fig. 1

Bottom Line: Adjusting for clinical and demographic factors, health status improved significantly during the follow-up (F(1,357) = 10.84, P = .001).Anhedonic patients reported poorer health status compared with non-anhedonic patients, with anhedonia exerting a stable effect over time (F(1,358) = 34.80, P < .001).Anhedonics experienced more benefits in terms of somatic and cognitive symptoms over time (F(1,358) = 13.00, P < .001).

View Article: PubMed Central - PubMed

Affiliation: Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.

ABSTRACT

Purpose: The effectiveness of cardiac rehabilitation (CR) in patients with coronary artery disease (CAD) is moderated by negative emotions and clinical factors, but no studies evaluated the role of positive emotions. This study examined whether anhedonia (i.e. the lack of positive affect) moderated the effectiveness of CR on health status and somatic and cognitive symptoms.

Methods: CAD patients (n = 368) filled out the Hospital Anxiety and Depression Scale (HADS) to assess anhedonia at the start of CR, and the Short-Form Health Survey (SF-36) and the Health Complaints Scale (HCS) at the start of CR and at 3 months to assess health status and somatic and cognitive symptoms, respectively.

Results: Adjusting for clinical and demographic factors, health status improved significantly during the follow-up (F(1,357) = 10.84, P = .001). Anhedonic patients reported poorer health status compared with non-anhedonic patients, with anhedonia exerting a stable effect over time (F(1,358) = 34.80, P < .001). Somatic and cognitive symptoms decreased over time (F(1,358) = 3.85, P = .05). Anhedonics experienced more benefits in terms of somatic and cognitive symptoms over time (F(1,358) = 13.00, P < .001).

Conclusion: Anhedonic patients reported poorer health status and higher levels of somatic and cognitive symptoms prior to and after CR. Somatic and cognitive symptoms differed as a function of anhedonia over time, but health status did not. Anhedonia might provide a new avenue for secondary prevention in CAD.

Show MeSH
Related in: MedlinePlus