Der zusätzliche Effekt psychologischer Interventionen im Vergleich zur trainingsbasierten Rehabilitation alleine auf die Endpunkte Depressivität, Angst und Stress bei kardial erkrakten Patient*innen - eine Metaanalyse

by Catharina Anna Kuncewicz
Doctoral thesis
Date of Examination:2025-12-08
Date of issue:2025-12-02
Advisor:Prof. Dr. Christoph Herrmann-Lingen
Referee:Prof. Dr. Dirk Wedekind
Referee:Dr. Anja PD. Sandek
Persistent Address: http://dx.doi.org/10.53846/goediss-11672

 

 

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Abstract

English

Psychological interventions are often added to exercise-based cardiac rehabilitation (ebCR) for patients with cardiovascular disease, but it remains unclear to what extent these interventions provide additional mental health benefits beyond training-based rehabilitation alone. Design: Meta-analysis. Methods: Randomized controlled and controlled cohort trials (1995–2017) comparing ebCR with or without predefined psychosocial interventions were evaluated based on prespecified criteria. Results: Of 15,373 records, 15 studies met inclusion criteria. Study quality was low to moderate and heterogeneity substantial. Psychological interventions showed a small trend toward reduced depressive symptoms (standardized mean difference –0.13, 95% CI –0.30 to 0.05), with no additional effects on anxiety. A post hoc analysis examining changes over time indicated inconsistent assessment schedules and baseline imbalances between studies. Conclusions: Specific psychological interventions delivered alongside ebCR in cardiac patients may help reduce depressive symptoms, but considerable uncertainty remains regarding the conditions under which these interventions are most effective. The post hoc findings underscore the need for future trials with more standardized assessment schedules and improved baseline comparability to allow more reliable evaluation of effects over time.
Keywords: coronary artery disease; depression; anxiety; rehabilitation; psychological interventions; cardiac patients; metanalysis; effect over time