The Support, Education, and Research in Chronic Heart Failure Study (SEARCH): a mindfulness-based psychoeducational intervention improves depression and clinical symptoms in patients with chronic heart failure.
Martin J Sullivan, Laura Wood, Jennifer Terry, Jeff Brantley, Ann Charles, Vicky McGee, Diane Johnson, Mitchell W Krucoff, Beth Rosenberg, Hayden B Bosworth, Kirkwood Adams, Michael S Cuffe
American heart journal January 2009 DOI: 10.1016/j.ahj.2008.08.033 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective cohort study Peer reviewed |
|---|---|
| Sample size | 208 |
| Population | Adults with chronic heart failure and left ventricular ejection fraction ≤40% |
| Intervention | Mindfulness-based psychoeducational intervention |
| Duration | 8-week intervention, follow-up at 3, 6, and 12 months |
| Measures | Center of Epidemiology - Depression, Profile of Mood States, Kansas City Cardiomyopathy Questionnaire symptom scale, Kansas City Cardiomyopathy Questionnaire clinical score |
| Topics | Depression Meditation |
| Key findings | The intervention reduced anxiety (Profile of Mood States, P = .003) and depression (Center of Epidemiology - Depression, P = .05), and improved symptoms and clinical scores on the Kansas City Cardiomyopathy Questionnaire over time, but effects on mood attenuated at 1 year. No treatment effect on death/rehospitalization at 1 year. |
Abstract
The Support, Education, and Research in Chronic Heart Failure (SEARCH) study was designed to assess the impact of a mindfulness-based psychoeducational intervention on clinical outcomes, depression, and quality of life in patients with chronic heart failure (CHF). Although research has shown that psychosocial factors including depression are important risk factors for adverse events in patients with CHF, no large clinical trials have investigated the efficacy of psychosocial interventions to reduce these factors in this population. This was a prospective cohort study of 208 adults with left ventricular ejection fraction < or =40% and CHF geographically assigned to treatment or control groups with follow-up at 3, 6, and 12 months. Treatment groups met weekly for 8 consecutive weeks for training in mindfulness meditation, coping skills, and support group discussion. Subjects had a mean age of 61 years, left ventricular ejection fraction 26%, and median New York Heart Association class II. The majority were treated with angiotensin-converting enzyme inhibitors (80%) and beta-blockers (86%). At baseline, patients in the treatment group had more severe CHF with higher New York Heart Association class (P = .0209) and more severe psychological distress (Center of Epidemiology - Depression, Profile of Mood States; P < .05). When compared with controls, treatment resulted in lower anxiety (Profile of Mood States, P = .003), depression (Center of Epidemiology - Depression, P = .05), improved symptoms (Kansas City Cardiomyopathy Questionnaire symptom scale, P = .033) and clinical scores (Kansas City Cardiomyopathy Questionnaire clinical score, P = .024) over time. There were no treatment effects on death/rehospitalization at 1 year. An 8-week mindfulness-based psychoeducational intervention reduced anxiety and depression; this effect was attenuated at 1 year. Importantly, the intervention led to significantly better symptoms of CHF at 12 months compared to control subjects. Our results suggest that interventions of this type might have a role in optimal therapy for CHF.
Comparable studies
Other observational and cohort studies on depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Metacognitive awareness and prevention of relapse in depression: Empirical evidence. Residually depressed patients and nondepressed controls; recovered depressed patients | 2002 | Observational cohort with intervention components | |
| Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. Patients with treatment-resistant depression | 2017 | Observational cohort | n = 19 |
| Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report Patients with a depressive disorder | 2015 | Observational study | |
| Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder | 2012 | Observational cohort | n = 30 |
| Altered peripheral immune profiles in treatment-resistant depression: response to ketamine and prediction of treatment outcome Healthy controls and actively depressed patients with treatment-resistant depression... | 2017 | Observational cohort | n = 59 |
Citations in the library
Cited by 24
- Mindfulness and Psychotherapy FOCUS: The Journal of Lifelong Learning in Psychiatry 2010
- Mindfulness-Based Interventions for Physical Conditions: A Narrative Review Evaluating Levels of Evidence ISRN Psychiatry November 14, 2012
- Mindfulness-Based Interventions for Physical and Psychological Wellbeing in Cardiovascular Diseases: A Systematic Review and Meta-Analysis Brain Sciences May 29, 2021
- Phone-Delivered Mindfulness Training for Patients with Implantable Cardioverter Defibrillators: Results of a Pilot Randomized Controlled Trial Annals of Behavioral Medicine April 19, 2013
- Design and Methods for a Pilot Study of a Phone-Delivered, Mindfulness-Based Intervention in Patients with Implantable Cardioverter Defibrillators Evidence-based Complementary and Alternative Medicine 2012
and 19 more in the library
Cites 4
- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 2000
- Stress Reduction through Mindfulness Meditation Psychotherapy and Psychosomatics February 18, 2010
- Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research July 1, 2004
- Mindfulness-based stress reduction and health-related quality of life in a heterogeneous patient population. General Hospital Psychiatry July 1, 2001