title: Anhedonia is associated with poor health status and more somatic and cognitive symptoms in patients with coronary artery disease.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: Aline J
authors.initials: AJ
authors.lastname: Pelle
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
authors.forename: Ruud A M
authors.initials: RA
authors.lastname: Erdman
authors.forename: Marten
authors.initials: M
authors.lastname: Kazemier
authors.forename: Marquita
authors.initials: M
authors.lastname: Spiering
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
mesh_terms: D000223:Adaptation, Psychological; D000339:Affect; D000367:Age Factors; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000473:pathology / Q000523:psychology*; D003324:Coronary Artery Disease / Q000150:complications / Q000473:pathology / Q000523:psychology* / Q000534:rehabilitation; D019263:Dysthymic Disorder / Q000473:pathology / Q000523:psychology*; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D025341:Principal Component Analysis; D011594:Psychometrics; D018570:Risk Assessment; D012307:Risk Factors; D013001:Somatoform Disorders / Q000473:pathology / Q000523:psychology*; D013223:Statistics as Topic; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013995:Time