BA for Depression in HF
Trial question
What is the effect of behavioral activation psychotherapy in patients with HF and depression?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
42.0% female
58.0% male
N = 416
416 patients (173 female, 243 male)
Inclusion criteria: patients with HF and depression
Key exclusion criteria: imminent danger to self or others; cognitive impairments; bipolar, psychotic, or substance-induced disorders; active treatment for depression
Interventions
N=208 behavioral activation psychotherapy (an evidence-based manualized treatment for depression promoting engagement in personalized pleasurable activities)
N=208 antidepressant medication management (administration of antidepressants using the evidence-based collaborative care model)
Primary outcome
Patient Health Questionnaire 9-Item score at 6 months
7.53
8.09
8.1 points
6.1 points
4.0 points
2.0 points
0.0 points
Behavioral activation
psychotherapy
Antidepressant medication
management
No significant
difference ↔
No significant difference in Patient Health Questionnaire 9-Item score at 6 months (7.53 points vs. 8.09 points; MD -0.1, 95% CI -0.33 to 1.13)
Secondary outcomes
Significant increase in physical health-related QoL at 6 months, measured using the Short-Form 12-Item version 2 (38.82 vs. 37.12 ; MD 2.13, 95% CI 0.06 to 4.2)
No significant difference in mental health-related QoL at 6 months, measured using the Short-Form 12-Item version 2 (47.33 vs. 46.85 ; AD 0.48 , 95% CI -33.48 to 34.44)
No significant difference in Kansas City Cardiomyopathy Questionnaire score at 6 months (64.35 points vs. 61.43 points; AD 2.92 points, 95% CI -1.53 to 7.37)
Conclusion
In patients with HF and depression, behavioral activation psychotherapy was not superior to antidepressant medication management with respect to Patient Health Questionnaire 9-Item score at 6 months.
Reference
Waguih William IsHak, Michele A Hamilton, Samuel Korouri et al. Comparative Effectiveness of Psychotherapy vs Antidepressants for Depression in Heart Failure: A Randomized Clinical Trial. JAMA Netw Open. 2024 Jan 2;7(1):e2352094.
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