title: Depression and anxiety symptoms affect change in exercise capacity during cardiac rehabilitation.
abstract: BACKGROUND
  To study whether symptoms of depression and anxiety would affect changes in exercise capacity and body mass index (BMI) during rehabilitation.
  
  
  METHODS
  Comprehensive cardiac outpatient rehabilitation intervention program.
  
  
  METHODS
  We investigated exercise capacity, BMI, and symptoms of depression and anxiety before and after cardiac rehabilitation in 114 patients with coronary artery disease. The Hospital Anxiety and Depression Scale (HADS) was applied to assess symptoms of depression (HADS-D) and anxiety (HADS-A).
  
  
  RESULTS
  Exercise capacity increased (127+/-47 vs. 144+/-51 watts, P<0.001) and symptoms of depression (4.0+/-3.6 vs. 2.7+/-2.7, P<0.001) and anxiety (5.4+/-4.4 vs. 4.1+/-3.6, P<0.001) decreased with the program, whereas BMI did not change. After controlling for covariates, HADS-D (r=-0.19, P=0.47) and HADS-A (r=0.17, P<0.09) correlated with change in exercise capacity. Change in HADS-A also correlated with that in exercise capacity (r=0.18, P<0.06). Changes in depression and anxiety were not significantly related to those in BMI.
  
  
  CONCLUSIONS
  Symptoms of depression and anxiety affected change in exercise capacity during cardiac rehabilitation. Depressive symptoms may impair improvement in exercise capacity, thereby mitigating the cardiovascular benefit achieved by cardiac rehabilitation programs.
authors.affiliation: Department of General Internal Medicine, Bern University Hospital, Inselspital, and University of Bern, Switzerland.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Egger
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Schmid
authors.forename: Raphaela Walker
authors.initials: RW
authors.lastname: Schmid
authors.forename: Hugo
authors.initials: H
authors.lastname: Saner
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D015992:Body Mass Index; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D003863:Depression / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome