title: Impact of depression treatment on mental and physical health-related quality of life of cardiac patients: a meta-analysis.
abstract: OBJECTIVE
  : To conduct a meta-analysis evaluating the effectiveness of depression treatment on mental and physical health-related quality of life (HRQOL) of cardiac patients.
  
  
  METHODS
  : Studies were identified using medical, health, psychiatry, psychology, and social sciences databases. Inclusion criteria were (1) 1 or more control conditions, (2) random assignment to condition after admission for myocardial infarction (MI)/acute coronary syndrome, after recording positive results on a depression screener, (3) documentation of depression symptoms at baseline, (4) depression management as a component of the rehabilitation/intervention, (5) validated measure of HRQOL as an outcome, at minimum 6-month followup. For meta-analysis, mental and physical HRQOL were the end points studied, using standardized mean differences for continuous outcome measures, with 95% confidence intervals. Heterogeneity was explored by calculating I statistic.
  
  
  RESULTS
  : Five randomized controlled trials included in the analysis represented 2105 participants (1058 intervention vs 1047 comparator). Compared with a comparator group at 6 months, a test for overall effect demonstrated statistically significant improvements in mental HRQOL in favor of the intervention (standardized mean differences = -0.29 [-0.38 to -0.20], [P < .00001]; I = 0%). Depression treatment had a modest yet significant impact on physical HRQOL (standardized mean differences = -0.14 [-0.24 to -0.04] [P = .009]; I = 15%).
  
  
  CONCLUSIONS
  : While the impact of post-MI depression interventions on physical HRQOL is modest, treatment can improve mental HRQOL in a significant way. Future research is required to develop and evaluate a program that can achieve vital improvements in overall HRQOL, and potentially cardiovascular outcomes, of cardiac patients.
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. o’neil@med.monash.edu.au
authors.forename: Adrienne
authors.initials: A
authors.lastname: O'Neil
authors.forename: Kristy
authors.initials: K
authors.lastname: Sanderson
authors.forename: Brian
authors.initials: B
authors.lastname: Oldenburg
authors.forename: C Barr
authors.initials: CB
authors.lastname: Taylor
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006304:Health Status; D006801:Humans; D008603:Mental Health; D009203:Myocardial Infarction / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D018579:Patient Selection; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents