title: Effects of interventions on depression in heart failure: a systematic review.
abstract: OBJECTIVE
  We sought to conduct a systematic review to evaluate the effects of interventions on depression in adults with heart failure (HF).
  
  
  METHODS
  Published, peer-reviewed, English-language, prospective interventional studies were identified in a search of Medline, CINAHL, PsychINFO, and the Cochrane Libraries of Systematic Reviews and Clinical Trials from 1996 through August 2011 and relevant bibliographies. Eligible studies included patients with New York Heart Association functional class II and III HF with experimental or quasiexperimental designs and preintervention and postintervention measures of depression. Ineligible studies were nonpharmacologic with a sample size <50, and drug studies without a comparison group.
  
  
  RESULTS
  Twenty-three experimental and quasiexperimental studies that enrolled a total of 3564 persons with HF contributed evidence about 6 types of interventions: selective serotonin reuptake inhibitors (SSRIs), an erythropoiesis-stimulating agent, exercise, disease management programs, complementary and alternative medicine (CAM), and a multimodal intervention of cognitive behavioral therapy and exercise. Studies with SSRIs examined effects of sertraline, paroxetine, and citalopram. The CAM interventions included tai chi, progressive muscle relaxation therapy, and mindfulness-based stress reduction.
  
  
  CONCLUSIONS
  Evidence is strong that pharmacology and CAM may improve depression. Moderate evidence supports the use of exercise. A strong body of evidence indicates that disease management programs do not improve depression. This review does not support the development of guidelines for treatment of depression in persons with HF because evidence is insufficient and, at times, contradictory.
authors.affiliation: University of Maryland Medical Center, Baltimore, Maryland, USA.
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Woltz
authors.forename: Deborah W
authors.initials: DW
authors.lastname: Chapa
authors.forename: Erika
authors.initials: E
authors.lastname: Friedmann
authors.forename: Heesook
authors.initials: H
authors.lastname: Son
authors.forename: Bimbola
authors.initials: B
authors.lastname: Akintade
authors.forename: Sue Ann
authors.initials: SA
authors.lastname: Thomas
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy* / Q000209:etiology; D006333:Heart Failure / Q000150:complications* / Q000523:psychology; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents