title: Cognitive behavioral therapy for depression improves pain and perceived control in cardiac surgery patients.
abstract: Depression after cardiac surgery (CS) is associated with increased pain and decreased sleep quality. While cognitive behavioral therapy (CBT) aimed at depression is effective in relieving depressive symptoms after cardiac surgery, little is known about its ability to ameliorate other common postoperative problems that affect recovery and quality of life.
  
  
  
  The purpose of this study was to evaluate the effects of CBT for depression on pain severity, pain interference, sleep, and perceived control in patients recovering from CS.
  
  
  
  Depressed patients recovering from CS were randomized to receive either eight weeks of CBT or usual care. At baseline and post-intervention, patients completed questionnaires for depressive symptoms, pain, sleep, and perceived control. Group comparisons were conducted using t-tests or chi square analysis. Repeated measures analysis was used to assess the effect of the intervention in changes over time.
  
  
  
  The sample (n=53) included 16.9% women and had a mean age of 67.8±9.2 years. CBT for depression increased perceived control (p<0.001) and decreased pain interference (p=0.02) and pain severity (p=0.03). Group effects remained significant (p<0.05) for perceived control and pain interference and a trend was observed for pain severity (p<0.10) after controlling for variables that differed at baseline. There were no group differences in sleep disturbance over time.
  
  
  
  A depression-focused CBT intervention yields benefits in other common postoperative problems, specifically improved perceived control and decreased pain in depressed cardiac surgery patients.
authors.affiliation: School of Nursing, University of California, USA ldoering@sonnet.ucla.edu.
authors.forename: Lynn V
authors.initials: LV
authors.lastname: Doering
authors.affiliation: School of Nursing, California State University, Long Beach, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: McGuire
authors.affiliation: School of Nursing, University of California, USA.
authors.forename: Jo-Ann
authors.initials: JA
authors.lastname: Eastwood
authors.affiliation: School of Nursing, University of California, USA.
authors.forename: Belinda
authors.initials: B
authors.lastname: Chen
authors.affiliation: School of Nursing, California State University, Fullerton, USA.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Bodán
authors.affiliation: Cedars-Sinai Heart Institute, USA.
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Czer
authors.affiliation: Cousins Center for Psychoneuroimmunology, University of California, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Irwin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications* / Q000601:surgery; D015928:Cognitive Behavioral Therapy; D003866:Depressive Disorder / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D010147:Pain Measurement / Q000523:psychology*; D011183:Postoperative Complications / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Cardiovascular disease; cognitive behavioral therapy; depression; pain