title: Improvement in psychosocial functioning during an intensive cardiovascular lifestyle modification program.
abstract: OBJECTIVE
  Psychosocial factors have significant effects on development and progression of coronary artery disease (CAD), but appropriate strategies for clinical management of multiple risk factors in persons with CAD are not well defined. This study evaluated changes in psychosocial functioning in patients with cardiovascular disease participating in an intensive lifestyle modification program.
  
  
  METHODS
  One hundred seventy-six patients participated in a prospective, nonrandomized intervention designed to stabilize or reverse progression of CAD through dietary changes, exercise, stress management, and group support. Three examinations over the course of 1 year assessed psychosocial functioning, physiological and biochemical CAD risk factors, and risk for future coronary events.
  
  
  RESULTS
  Most patients showed significant improvements in mental health and quality of life as well as significant reductions in traditional CAD risk factors and cardiovascular risk. The intervention was effective in producing clinically meaningful changes in psychosocial functioning. Response rates were approximately 90% for clinical depression, 85% for stress, and 87% for mental health.
  
  
  CONCLUSIONS
  A comprehensive lifestyle intervention can reduce multiple psychometric risk factors and produce clinically relevant improvement in measures of depression, stress, and mental health. Cardiac rehabilitation programs that effectively address psychosocial and physiological outcomes may be valuable alternatives or supplements to pharmacologic treatments for reducing multiple psychosocial risk factors for CAD.
authors.affiliation: Integrative Cardiac and Metabolic Health Program, Windber Research Institute and Windber Medical Center, Windber, PA 15963, USA.
authors.forename: James
authors.initials: J
authors.lastname: Vizza
authors.forename: David M
authors.initials: DM
authors.lastname: Neatrour
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Felton
authors.forename: Darrell L
authors.initials: DL
authors.lastname: Ellsworth
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D003324:Coronary Artery Disease / Q000150:complications / Q000178:diet therapy / Q000523:psychology / Q000534:rehabilitation*; D003863:Depression / Q000209:etiology / Q000517:prevention & control; D018752:Diet, Fat-Restricted; D005081:Exercise Therapy; D005260:Female; D006791:Hostility; D006801:Humans; D008019:Life Style; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015397:Program Evaluation; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome