Researchers from the UCLA School of Nursing evaluated a program of early, home based cognitive behavioral therapy (CBT) program to remediate depression in patients recovering from cardiac surgery.
They conducted a randomized controlled trial and enrolled 808 patients who were screened for depressive symptoms, using the Beck Depression Inventory (BDI) in the hospital and 1 month later. Patients were also interviewed using the Structured Clinical Interview for DSM-IV; those who met criteria for clinical depression (n = 81) were randomized to CBT (n = 45) or usual care (UC; n = 36). After completion of the UC period, 25 individuals were offered later CBT (UC + CBT).
The outcomes were evaluated after 8 weeks. Compared with the Usual Care group, the CBT group had greater decline in depression scores and greater remission of clinical depression.
Compared with the early CBT group (median time from surgery to CBT, 45.5 days) the later UC + CBT group (median time from surgery to CBT, 122 days) also experienced a reduction in depression scores, but the effect was smaller and remission rates between the two groups did not differ.
The investigators conclude that early home CBT is effective in depressed post-cardiac surgery patients. Early treatment is associated with greater symptom reduction than similar therapy given at a later time after surgery.