Does improving mood in depressed patients alter factors that may affect cardiovascular disease risk?
To determine if improvement in mood would ameliorate autonomic dysregulation, HPA dysfunction, typical risk factors and C-reactive protein in depressed patients with elevated cardiovascular disease risk (CVD), 48 depressed participants with elevated cardiovascular risk factors were randomized to a cognitive behavioral intervention (CBT) or a waiting list control (WLC) condition. Twenty non-depressed age and risk-matched controls were also recruited. Traditional risk factors (e.g., lipids, blood pressure) and C-reactive protein were assessed pre- and post-treatment six months later. Subjects also underwent a psychophysiological stress test while cardiovascular physiology was measured. Salivary cortisol was measured during the day and during the psychological stress test. At post-treatment, the CBT subjects were significantly less depressed than WLC subjects. There was no significant difference in change scores on any of the traditional risk factors or C-reactive protein, cortisol measures, or cardiovascular physiology, except for triglyceride levels and heart rate, which were significantly lower in treatment compared to control subjects. The normal controls exhibited no change in the variables measured during the same time. A significant improvement in mood may have little impact on most traditional or atypical risk factors, cortisol or cardiophysiology.
Taylor
C Barr
CB
Department of Psychiatry and Behavioral Sciences, Stanford Medical Center, 401 Quarry Rd, Room 1316, Stanford, CA 94305-5722, USA. btaylor@stanford.edu
Conrad
Ansgar
A
Wilhelm
Frank H
FH
Strachowski
Diane
D
Khaylis
Anna
A
Neri
Eric
E
Giese-Davis
Janine
J
Roth
Walton T
WT
Cooke
John P
JP
Kraemer
Helena
H
Spiegel
David
D
D000339:Affect / Q000502:physiology*; D000368:Aged; D019540:Area Under Curve; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000523:psychology; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003863:Depression / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012463:Saliva / Q000378:metabolism; D013315:Stress, Psychological / Q000523:psychology
D002097:C-Reactive Protein; D006854:Hydrocortisone