With as many as 20% of cardiac rehabilitation patients being depressed, stressed or anxious, their success and participation in healing therapies may hinge on how well clinicians address these mental health issues, researchers claim.

“Heart patients living with depression are more likely to feel despondent and hopeless, which reduces their ability to manage their symptoms,” said study author Angela Rao, BN, of the University of Technology Sydney, Australia. “They may minimize successes and exaggerate failures, thereby reducing their motivation to exercise and complete a cardiac rehabilitation program.”

People with anxiety may face similar mental roadblocks, underestimating their ability to walk on a treadmill during a rehabilitation class for example, said Rao.

The findings come from data on depression, stress and anxiety taken from more than 4,700 cardiac rehabilitation patients. Fully 18% of participants had moderate to extremely severe depression, 28% had anxiety and 13% experienced stress. 

Individuals with moderate depression were significantly more likely to quit cardiac rehabilitation compared to those with no or mild symptoms. Around one-half of those with moderate depression or anxiety who completed cardiac rehabilitation did not show significant improvement in these conditions.

Rao urged clinicians to screen for depression and anxiety at the start and end of rehabilitation to identify people in need of additional help. Stress management, cognitive behavioral therapies, meditation and mindfulness can improve mental health and raise participation, she said.

The study was published today – World Mental Health Day – in the European Journal of Preventive Cardiology.