title: Psychological rehabilitation after myocardial infarction: multicentre randomised controlled trial.
abstract: OBJECTIVE
  To evaluate rehabilitation after myocardial infarction.
  
  
  METHODS
  Randomised controlled trial of rehabilitation in unselected myocardial infarction patients in six centres, baseline data being collected on admission and by structured interview (of patients and spouses) shortly after discharge and outcome being assessed by structured interview at six months and clinical examination at 12 months.
  
  
  METHODS
  Six district general hospitals.
  
  
  METHODS
  All 2328 eligible patients admitted over two years with confirmed myocardial infarction and discharged home within 28 days.
  
  
  METHODS
  Rehabilitation programmes comprising psychological therapy, counselling, relaxation training, and stress management training over seven weekly group outpatient sessions for patients and spouses.
  
  
  METHODS
  Anxiety, depression, quality of life, morbidity, use of medication, and mortality.
  
  
  RESULTS
  At six months there were no significant differences between rehabilitation patients and controls in reported anxiety (prevalence 33%) or depression (19%). Rehabilitation patients reported a lower frequency of angina (median three versus four episodes a week), medication, and physical activity. At 12 months there were no differences in clinical complications, clinical sequelae, or mortality.
  
  
  CONCLUSIONS
  Rehabilitation programmes based on psychological therapy, counselling, relaxation training, and stress management seem to offer little objective benefit to patients who have experienced myocardial infarction compared with previous reports of smaller trials.
authors.affiliation: University of Wales College of Medicine, Llandough Hospital, Cardiff.
authors.forename: D A
authors.initials: DA
authors.lastname: Jones
authors.forename: R R
authors.initials: RR
authors.lastname: West
mesh_terms: D000787:Angina Pectoris / Q000188:drug therapy; D001007:Anxiety / Q000209:etiology; D003863:Depression / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D009203:Myocardial Infarction / Q000523:psychology / Q000534:rehabilitation*; D005996:Nitroglycerin / Q000627:therapeutic use; D010342:Patient Acceptance of Health Care; D012907:Smoking; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D005996:Nitroglycerin