Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
Material for Online Appendix
PICO criteria for the review of characteristics of psychological interventions that
improve depression in CHD ........................................................................................ 2
eTable 1 Search strategy: CENTRAL database for controlled trials ........................... 4
eTable 2 Search strategy: MEDLINE ........................................................................ 10
eTable 3 Search strategy: PSYCINFO ..................................................................... 13
eTable 4 Search strategy: EMBASE ......................................................................... 16
eTable 5 Search strategy: CINAHL .......................................................................... 19
eFigure 1 Selection of studies for inclusion in the review ......................................... 23
eTable 6: Characteristics of study population
22
eTable 7: Characteristics of the interventions ........................................................... 35
eTable 8: Quality of the studies ................................................................................ 46
eFigure 2 Funnel plot including imputed values from Duval and Tweedie’s Trim and
Fill procedure. ........................................................................................................... 52
eTable 9 Effects of individual treatment components from studies recruiting
depressed subjects................................................................................................... 52
eTable 9 Effects of individual treatment components from studies recruiting
depressed subjects................................................................................................... 53
References to studies included in meta analysis ...................................................... 54
1
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
PICO criteria for the review of characteristics of psychological interventions that
improve depression in CHD
Study type: Randomized controlled trials, reports written in English.
Population: Patients of any age with Coronary Heart Disease (stable angina, unstable
angina, myocardial infarction, acute coronary syndrome or pre or post coronary intervention).
Populations with heart failure or implantable cardiac defibrillators could only be included if
there was evidence in the study report or provided by the author that >80% of included
subjects had CHD.
Intervention: Patient randomized to a psychological intervention, defined as:
“a synchronous intervention between patient(s) and paraprofessionals which seeks to
change knowledge, attitudes, beliefs, emotions, skills and/or behavior concerning health and
well-being”
Psychological interventions were defined as involving one or more of the following
components:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
General education: Basic provision of information, commonly using didactic
techniques.
General discussion: Discussion within a group, facilitated by professionals or
lay leaders.
Skills training: Teaching of practical skills e.g. blood sugar results, meal
planning.
Exercise: Specific exercise sessions as part of intervention.
Relapse prevention: Discussion of how to maintain behavior to minimize
cardiac risk factors in the future and prevent relapses.
Behavior therapy: Use of behavioral techniques, such as goal setting,
reinforcement, modeling.
Problem solving: Identification of problems or barriers to behavior and
strategies to overcome them.
CBT: Teaching or use of behavioral or cognitive techniques to influence
mental health
Social support: Teaching techniques to specifically help participants improve
social support.
Relaxation: Actual practice of relaxation, may include imagery or distraction
techniques.
Biofeedback: Use of biological feedback to assist relaxation.
Miscellaneous: Psychological intervention not described in sufficient detail e.g.
stress management.
Control: The following designs were included:
1) Psychological intervention versus Control (waiting list, usual care etc)
2) Psychological intervention plus Medication versus Medication
3) Psychological intervention plus Technology versus Technology
The following designs will be excluded:
1) Psychological intervention versus Psychological intervention
2) Psychological intervention versus (Medication or Technology)
2
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
3) Psychological intervention plus (Medication or Technology) versus Control
Outcomes: For inclusion, studies must include a standardized measure of depression at
outcome
3
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
eTable 1 Search strategy: CENTRAL database for controlled trials
#1
“Beck depression inventory”:ti,ab,kw OR BDI:ti,ab
#2
“Zung self rating depression scale”:ti,ab OR ZSDS:ti,ab
#3
“diagnostic interview schedule”:ti,ab
#4
“medical outcomes study”:ti,ab
#5
“general health questionnaire”:ti,ab,kw OR GHQ:ti,ab
#6
“schedule for affective disorders and schizophrenia”:ti,ab
#7
“millon behavior health inventory”:ti,ab OR “millon behavioral health
inventory”:ti,ab OR MBHI:ti,ab
#8
“cognitive behavior assessment hospital form”:ti,ab OR “cognitive
behavioral assessment hospital form”:ti,ab OR “cognitive behaviour
assessment hospital form”:ti,ab OR “cognitive behavioural assessment
hospital form”:ti,ab
#9
“depression anxiety stress scale”:ti,ab
#10
“SCL-90-R”:ti,ab OR “Symptom checklist 90”:ti,ab,kw
#11
“structured clinical interview”:ti,ab
#12
“center for epidemiological studies depression scale”:ti,ab,kw OR
CESD:ti,ab
#13
“hamilton rating scale for depression”:ti,ab OR HAMD:ti,ab OR “HAMD”:ti,ab OR “Hamilton Scale”:ti,ab,kw
#14
(#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR
#11 OR #12 OR #13)
#15
MeSH descriptor Coronary Disease, this term only
#16
MeSH descriptor Angina, Unstable, this term only
#17
MeSH descriptor Myocardial Infarction, this term only
#18
MeSH descriptor Heart Diseases, this term only
#19
MeSH descriptor Heart Arrest, this term only
#20
MeSH descriptor Angina Pectoris, this term only
#21
MeSH descriptor Coronary Artery Bypass, this term only
#22
MeSH descriptor Myocardial Ischemia, this term only
#23
MeSH descriptor Smoking Cessation, this term only
#24
Angina:ti,ab
#25
Cabg:ti,ab OR chd:ti,ab
#26
“coronary bypass”:ti,ab
#27
“coronary disease”:ti,ab
#28
“coronary thrombosis”:ti,ab
#29
“coronary angioplasty”:ti,ab
#30
“myocardial infarct”:ti,ab OR “myocardial infarction”:ti,ab OR “myocardium
4
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
infarct”:ti,ab OR “myocardium infarction”:ti,ab
#31
“myocardial ischemia”:ti,ab OR “myocardium ischemia”:ti,ab
#32
“myocardial ischaemia”:ti,ab OR “myocardium ischaemia”:ti,ab
#33
“heart infaction”:ti,ab,kw OR “heart infarct”:ti,ab
#34
“heart disease”:ti,ab,kw OR “heart diseases”:ti,ab
#35
“cardiac disease”:ti,ab OR “cardiac diseases”:ti,ab
#36
“acute coronary syndrome”:ti,ab
#37
“cardiac inpatient”:ti,ab OR “cardiac inpatients”:ti,ab
#38
“cardiac patient”:ti,ab OR “cardiac patients”:ti,ab
#39
“heart patient”:ti,ab OR “heart patients”:ti,ab
#40
“cardiac outpatient”:ti,ab OR “cardiac outpatients”:ti,ab
#41
"cardiovascular risk factor":ti,ab OR "coronary risk factor":ti,ab OR
"cardiac risk factor":ti,ab OR "cardiovascular risk factors":ti,ab OR
"coronary risk factors":ti,ab OR "cardiac risk factors":ti,ab
#42
“smoking cessation”:ti,ab
#43
Heart NEAR inpatient
#44
Heart NEAR outpatient
#45
“Coronary artery disease”:ti,ab,kw
#46
“coronary artery bypass graft”:ti,ab,kw
#47
“unstable angina pectoris”:ti,ab,kw
#48
“heart muscle ischemia”:ti,ab,kw
#49
(#15 OR #16 OR #17 OR #18 OR #19 OR #20 OR #21 OR #22 OR #23
OR #24 OR #25 OR #26 OR #27 OR #28 OR #29 OR #30 OR #31 OR
#32 OR #33 OR #34 OR #35 OR #36 OR #37 OR #38 OR #39 OR #40
OR #41 OR #42 OR #43 OR #44 OR #45 OR #46 OR #47 OR #48)
#50
psychoeducational NEXT program*
#51
psycho-educational NEXT program*
#52
psychoeducational NEXT therap*
#53
psycho-educational NEXT therap*
#54
psychoeducational NEXT outcome*
#55
psychoeducational NEXT treatment*
#56
psycho-educational NEXT treatment*
#57
Psychosocial NEXT program*
#58
Psychosocial NEXT therap*
#59
psycho-social NEXT therap*
#60
Psychosocial NEXT change*
#61
Psychosocial NEXT outcome*
#62
psycho-social NEXT outcome*
#63
Psychosocial NEXT variable*
5
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
#64
psycho-social NEXT variable*
#65
Psychosocial NEXT factor*
#66
psycho-social NEXT factor*
#67
Psychosocial NEXT effect*
#68
psycho-social NEXT effect*
#69
Psychosocial NEXT treatment*
#70
psycho-social NEXT treatment*
#71
Psychosocial NEXT rehabilitation*
#72
psycho-social NEXT rehabilitation*
#73
psychological NEXT distress
#74
psychological NEXT stress
#75
psychological NEXT rehabilitation
#76
psychological NEXT variable*
#77
psychological NEXT factor*
#78
psychological NEXT adaptation*
#79
psychological NEXT outcome*
#80
psychological NEXT therap*
#81
psychological NEXT change*
#82
psychological NEXT effect*
#83
Behavio* NEXT intervention*
#84
educational NEXT intervention*
#85
psychological NEXT intervention*
#86
psychosocial NEXT intervention*
#87
psycho-social NEXT intervention*
#88
psychoeducational NEXT intervention*
#89
psycho-educational NEXT intervention*
#90
Behavio* NEXT therap*
#91
Behavio* NEXT modification
#92
Psychopathology:ti,ab
#93
“autogenic training”:ti,ab
#94
Counseling:ti,ab OR Counselling:ti,ab
#95
“cognitive therapy”:ti,ab
#96
health NEXT education
#97
patient NEXT education
#98
motivational NEXT interview*
#99
“group psychotherapy”:ti,ab
#100 relaxation NEXT technique*
6
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
#101 relaxation NEXT training
#102 type-A NEXT behavior*
#103 type-A NEXT counsel*
#104 “type-a-behavior”:kw
#105 cardiac NEXT counsel*
#106 cardiac NEXT nurs*
#107 Telephone:ti,ab
#108 Group NEXT therapy
#109 lifestyle NEXT change*
#110 lifestyle NEXT management
#111 Self NEXT management
#112 Self NEXT care
#113 stress NEXT management
#114 anxiety NEXT management
#115 distress NEXT management
#116 Behavio* NEXT change*
#117 Behavio* NEXT program*
#118 health NEXT behavior*
#119 health NEXT behaviour*
#120 social NEXT support
#121 Support NEXT network*
#122 Structured NEXT intervention
#123 Brief NEXT intervention
#124 Structured NEXT follow-up
#125 Brief NEXT follow-up
#126 nurse-led:ti,ab
#127 “nurse delivered”:ti,ab
#128 “case-management”:ti,ab
#129 psychosocial NEXT nursing
#130 liaison NEXT nurs*
#131 Sick NEXT role
#132 “life event”:kw
#133 “lifestyle modification”:kw
#134 “adaptive behavior”:kw
#135 Vocational NEXT rehabilitation
#136 Mental NEXT stress
#137 Heart NEXT rehabilitation
7
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
#138 Cardiac NEXT anxiety
#139 MeSH descriptor Rehabilitation, this term only
#140 MeSH descriptor Psychotherapy, this term only
#141 MeSH descriptor Counseling, this term only
#142 MeSH descriptor Relaxation Techniques, this term only
#143 MeSH descriptor Psychotherapy, Group, this term only
#144 MeSH descriptor Adaptation, Psychological, this term only
#145 MeSH descriptor Patient Education as Topic, this term only
#146 MeSH descriptor Cognitive Therapy, this term only
#147 MeSH descriptor Behavior Therapy, this term only
#148 MeSH descriptor Health Behavior, this term only
#149 MeSH descriptor Rehabilitation, Vocational, this term only
#150 MeSH descriptor Stress, Psychological, this term only
#151 MeSH descriptor Stress, this term only with qualifier: PC
#152 MeSH descriptor Life Style, this term only
#153 MeSH descriptor Health Education, this term only
#154 MeSH descriptor Health Promotion, this term only
#155 MeSH descriptor Life Change Events, this term only
#156 MeSH descriptor Motivation, this term only
#157 MeSH descriptor Social Support, this term only
#158 MeSH descriptor Social Environment, this term only
#159 MeSH descriptor Self Care, this term only
#160 MeSH descriptor Sick Role, this term only
#161 MeSH descriptor Type A Personality, this term only
#162 MeSH descriptor Meditation, this term only
#163 MeSH descriptor Anxiety, this term only
#164 MeSH descriptor Psychopathology, this term only
#165 MeSH descriptor Autogenic Training, this term only
(#50 OR #51 OR #52 OR #53 OR #54 OR #55 OR #56 OR #57 OR #58
OR #59 OR #60 OR #61 OR #62 OR #63 OR #64 OR #65 OR #66 OR
#67 OR #68 OR #69 OR #70 OR #71 OR #72 OR #73 OR #74 OR #75
OR #76 OR #77 OR #78 OR #79 OR #80 OR #81 OR #82 OR #83 OR
#84 OR #85 OR #86 OR #87 OR #88 OR #89 OR #90 OR #91 OR #92
OR #93 OR #94 OR #95 OR #96 OR #97 OR #98 OR #99 OR #100 OR
#101 OR #102 OR #103 OR #104 OR #105 OR #106 OR #107 OR #108
#166
OR #109 OR #110 OR #111 OR #112 OR #113 OR #114 OR #115 OR
#116 OR #117 OR #118 OR #119 OR #120 OR #121 OR #122 OR #123
OR #124 OR #125 OR #126 OR #127 OR #128 OR #129 OR #130 OR
#131 OR #132 OR #133 OR #134 OR #135 OR #136 OR #137 OR #138
OR #139 OR #140 OR #141 OR #142 OR #143 OR #144 OR #145 OR
#146 OR #147 OR #148 OR #149 OR #150 OR #151 OR #152 OR #153
OR #154 OR #155 OR #156 OR #157 OR #158 OR #159 OR #160 OR
8
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
#161 OR #162 OR #163 OR #164 OR #165)
#167 (#14 AND #49)
#168 (#49 AND #166)
#169 (#167 OR #168)
#170 (#167 AND NOT #168)
9
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
eTable 2 Search strategy: MEDLINE
1
Coronary disease/
2
Angina, unstable/
3
Myocardial infarction/
4
Heart diseases/
5
Heart Arrest/
6
Angina pectoris/
7
Coronary artery bypass/
8
Myocardial ischemia/
9
smoking cessation/
10
angina.tw.
11
(cabg or chd).tw.
12
coronary bypass$.tw.
13
coronary disease$.tw.
14
coronary thrombo$.tw.
15
coronary angioplast$.tw.
16
myocard$ infarct$.tw.
17
myocard$ ischemi$.tw.
18
myocard$ ischaemi$.tw.
19
heart infarct$.tw.
20
heart disease$.tw.
21
cardiac disease$.tw.
22
acute coronary syndrome.tw.
23
cardiac inpatient$.tw.
24
cardiac patient$.tw.
25
heart patient$.tw.
26
cardiac outpatient$.tw.
27
((cardiovascular or coronary or cardiac) adj risk factor$).tw.
28
smoking cessation.tw.
29
(heart adj5 outpatient$).tw.
30
(heart adj5 inpatient$).tw.
31
or/1-30
32
((psychoeducational or psycho-educational) adj (program$ or therap$ or change$ or outcome$ or
effect$ or treatment$ or variable$ or factor$)).tw.
33
((psychosocial or psycho-social) adj (program$ or therap$ or change$ or outcome$ or variable$
or factor$ or change$ or effect$ or treatment$ or rehabilitation)).tw.
34
(psychological adj (distress or stress or rehabilitation or variable$ or factor$ or adaptation$ or
outcome$ or therap$ or change$ or effect$)).tw.
35
((behavio?ral or educational or psychological or psychosocial or psycho-social or
psychoeducational or psycho-educational) adj intervention$).tw.
36
(behavio?r$ adj therap$).tw.
10
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
37
(behavio?r$ adj modif$).tw.
38
psychopathology.tw.
39
autogenic training.tw.
40
counsel?ing.tw.
41
cognitive therapy.tw.
42
((health or patient) adj education).tw.
43
motivational interview$.tw.
44
group psychotherapy.tw.
45
relaxation technique$.tw.
46
(type-A adj (behavio?r$ or counsel?ing)).tw.
47
(cardiac adj (counsel?ing or nurs$)).tw.
48
telephone.tw.
49
group therapy.tw.
50
(lifestyle adj (change$ or management)).tw.
51
(self adj (management or care)).tw.
52
((stress or anxiety or distress) adj management).tw.
53
(behavio?r$ adj (change$ or program$)).tw.
54
health behavio?r$.tw.
55
social support.tw.
56
support network$.tw.
57
((structured or brief) adj (intervention or follow-up)).tw.
58
(nurse-led or nurse delivered).tw.
59
case-management.tw.
60
((psychosocial or psycho-social) adj nursing).tw.
61
liaison nurs$.tw.
62
Rehabilitation/
63
Psychotherapy/
64
Counseling/
65
Relaxation Techniques/
66
Psychotherapy, group/
67
Adaptation, psychological/
68
Patient education as topic/
69
Cognitive therapy/
70
Behavior Therapy/
71
Health behavior/
72
Rehabilitation, vocational/
73
Stress, psychological/
74
Stress/pc [Prevention & Control]
75
Lifestyle/
76
Health education/
11
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
77
Health promotion/
78
Life change events/
79
Motivation/
80
Social support/
81
Social environment/
82
Self-care/
83
Sick Role/
84
Type A personality/
85
Meditation/
86
Anxiety/
87
Psychopathology/
88
Autogenic Training/
89
or/32-88
90
Clinical Trial.pt.
91
randomized.tw.
92
placebo.tw.
93
dt.fs.
94
randomly.tw.
95
trial.tw.
96
groups.tw.
97
or/90-96
98
(animals not humans).sh.
99
97 not 98
100 31 and 89 and 99
101 limit 100 to yr="2007 - 2008"
12
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
eTable 3 Search strategy: PSYCINFO
1
Cardiovascular disorders/
2
Angina Pectoris/
3
Myocardial infarctions/
4
Heart disorders/
5
smoking cessation/
6
angina.tw.
7
(cabg or chd).tw.
8
coronary bypass$.tw.
9
coronary disease$.tw.
10
coronary thrombo$.tw.
11
coronary angioplast$.tw.
12
myocard$ infarct$.tw.
13
myocard$ ischemi$.tw.
14
myocard$ ischaemi$.tw.
15
heart infarct$.tw.
16
heart disease$.tw.
17
cardiac disease$.tw.
18
acute coronary syndrome.tw.
19
cardiac inpatient$.tw.
20
cardiac patient$.tw.
21
heart patient$.tw.
22
cardiac outpatient$.tw.
23
((cardiovascular or coronary or cardiac) adj risk factor$).tw.
24
smoking cessation.tw.
25
(heart adj5 outpatient$).tw.
26
(heart adj5 inpatient$).tw.
27
heart arrest.tw.
28
coronary artery bypass.tw.
29
or/1-28
30
((psychoeducational or psycho-educational) adj (program$ or therap$ or change$ or outcome$ or
effect$ or treatment$ or variable$ or factor$)).tw.
31
((psychosocial or psycho-social) adj (program$ or therap$ or change$ or outcome$ or variable$
or factor$ or change$ or effect$ or treatment$ or rehabilitation)).tw.
32
(psychological adj (distress or stress or rehabilitation or variable$ or factor$ or adaptation$ or
outcome$ or therap$ or change$ or effect$)).tw.
33
((behavio?ral or educational or psychological or psychosocial or psycho-social or
psychoeducational or psycho-educational) adj intervention$).tw.
34
(behavio?r$ adj therap$).tw.
35
(behavio?r$ adj modif$).tw.
13
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
36
psychopathology.tw.
37
autogenic training.tw.
38
counsel?ing.tw.
39
cognitive therapy.tw.
40
((health or patient) adj education).tw.
41
motivational interview$.tw.
42
group psychotherapy.tw.
43
relaxation technique$.tw.
44
(type-A adj (behavio?r$ or counsel?ing)).tw.
45
(cardiac adj (counsel?ing or nurs$)).tw.
46
telephone.tw.
47
group therapy.tw.
48
(lifestyle adj (change$ or management)).tw.
49
(self adj (management or care)).tw.
50
((stress or anxiety or distress) adj management).tw.
51
(behavio?r$ adj (change$ or program$)).tw.
52
health behavio?r$.tw.
53
social support.tw.
54
support network$.tw.
55
((structured or brief) adj (intervention or follow-up)).tw.
56
(nurse-led or nurse delivered).tw.
57
case-management.tw.
58
((psychosocial or psycho-social) adj nursing).tw.
59
liaison nurs$.tw.
60
sick role.tw.
61
psychological adjustment.tw.
62
Rehabilitation/
63
Psychotherapy/
64
Counseling/
65
exp Relaxation Therapy/
66
Group Psychotherapy/
67
Client Education/
68
Cognitive therapy/
69
Behavior Therapy/
70
Health behavior/
71
Rehabilitation, vocational/
72
Psychological Stress/
73
Lifestyle/
74
Health education/
75
Health promotion/
14
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
76
Life experiences/
77
Motivation/
78
Social support/
79
Social environment/
80
Self-care/
81
Illness behavior/
82
Type A personality/
83
Meditation/
84
Anxiety/
85
Psychopathology/
86
Autogenic Training/
87
Coronary Prone Behavior/
88
Cardiovascular Reactivity/
89
or/30-88
90
Randomi?ed controlled trial$.tw.
91
Controlled clinical trial$.tw.
92
"2000".md.
93
or/90-92
94
(animal not human).po.
95
93 not 94
96
(clin$ adj25 trial$).tw.
97
((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).tw.
98
placebo$.tw.
99
random$.tw.
100 or/96-99
101 100 not 94
102 101 not 95
103 "0430".md.
104 "0451".md.
105 (control$ or prospectiv$ or volunteer$).tw.
106 or/103-105
107 106 not 94
108 107 not (102 or 95)
109 95 or 102 or 108
110 109 and 89 and 29
111 limit 110 to yr="2007 - 2009"
15
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
eTable 4 Search strategy: EMBASE
1
Coronary Artery Disease/
2
Unstable Angina Pectoris/
3
Heart Infarction/
4
Heart disease/
5
Heart Arrest/
6
Angina pectoris/
7
Coronary artery bypass graft/
8
Heart Muscle ischemia/
9
smoking cessation/
10
angina.tw.
11
(cabg or chd).tw.
12
coronary bypass$.tw.
13
coronary disease$.tw.
14
coronary thrombo$.tw.
15
coronary angioplast$.tw.
16
myocard$ infarct$.tw.
17
myocard$ ischemi$.tw.
18
myocard$ ischaemi$.tw.
19
heart infarct$.tw.
20
heart disease$.tw.
21
cardiac disease$.tw.
22
acute coronary syndrome.tw.
23
cardiac inpatient$.tw.
24
cardiac patient$.tw.
25
heart patient$.tw.
26
cardiac outpatient$.tw.
27
((cardiovascular or coronary or cardiac) adj risk factor$).tw.
28
smoking cessation.tw.
29
(heart adj5 outpatient$).tw.
30
(heart adj5 inpatient$).tw.
31
or/1-30
32
((psychoeducational or psycho-educational) adj (program$ or therap$ or change$ or outcome$ or
effect$ or treatment$ or variable$ or factor$)).tw.
33
((psychosocial or psycho-social) adj (program$ or therap$ or change$ or outcome$ or variable$
or factor$ or change$ or effect$ or treatment$ or rehabilitation)).tw.
34
(psychological adj (distress or stress or rehabilitation or variable$ or factor$ or adaptation$ or
outcome$ or therap$ or change$ or effect$)).tw.
35
((behavio?ral or educational or psychological or psychosocial or psycho-social or
psychoeducational or psycho-educational) adj intervention$).tw.
16
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
36
(behavio?r$ adj therap$).tw.
37
(behavio?r$ adj modif$).tw.
38
psychopathology.tw.
39
autogenic training.tw.
40
counsel?ing.tw.
41
cognitive therapy.tw.
42
((health or patient) adj education).tw.
43
motivational interview$.tw.
44
group psychotherapy.tw.
45
relaxation technique$.tw.
46
(type-A adj (behavio?r$ or counsel?ing)).tw.
47
(cardiac adj (counsel?ing or nurs$)).tw.
48
telephone.tw.
49
group therapy.tw.
50
(lifestyle adj (change$ or management)).tw.
51
(self adj (management or care)).tw.
52
((stress or anxiety or distress) adj management).tw.
53
(behavio?r$ adj (change$ or program$)).tw.
54
health behavio?r$.tw.
55
social support.tw.
56
support network$.tw.
57
((structured or brief) adj (intervention or follow-up)).tw.
58
(nurse-led or nurse delivered).tw.
59
case-management.tw.
60
((psychosocial or psycho-social) adj nursing).tw.
61
liaison nurs$.tw.
62
sick role$.tw.
63
psychopathology.tw.
64
Heart Rehabilitation/
65
Psychotherapy/
66
Counseling/
67
Relaxation Training/
68
Group Therapy/
69
Adaptive Behavior/
70
Patient education/
71
Cognitive therapy/
72
Behavior Therapy/
73
Health behavior/
74
Vocational Rehabilitation/
75
Mental Stress/
17
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Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
76
Stress Management/
77
Lifestyle Modification/
78
Health education/
79
Health promotion/
80
Life event/
81
Motivation/
82
Social support/
83
Social environment/
84
Self-care/
85
Type A behavior/
86
Meditation/
87
Cardiac Anxiety/
88
Autogenic Training/
89
or/32-88
90
Randomi?ed controlled trial$.tw.
91
Controlled clinical trial.tw.
92
Randomized controlled trial.sh.
93
Randomization.sh.
94
Double blind procedure.sh.
95
Single-blind procedure.sh.
96
or/90-95
97
(Nonhuman not human).sh.
98
96 not 97
99
Clinical trial.tw.
100 exp Clinical Trial/
101 (clin$ adj25 trial$).ti,ab.
102 ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).ti,ab.
103 Placebo.sh.
104 placebo$.ti,ab.
105 random$.ti,ab.
106 Methodology.sh.
107 or/99-106
108 107 not 97
109 108 not 98
110 Comparative study.sh.
111 Evaluation/
112 Follow up.sh.
113 Prospective study.sh.
114 (control$ or prospectiv$ or volunteer$).ti,ab.
115 or/110-114
18
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Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
116 115 not 97
117 116 not (98 or 109)
118 109 or 98 or 117
119 118 and 89 and 31
120 limit 119 to yr="2007 - 2008"
eTable 5 Search strategy: CINAHL
1
Coronary disease/
2
Angina, unstable/
3
Myocardial infarction/
4
Heart diseases/
5
Heart Arrest/
6
Angina pectoris/
7
Coronary artery bypass/
8
Myocardial ischemia/
9
smoking cessation/
10
angina.tw.
11
(cabg or chd).tw.
12
coronary bypass$.tw.
13
coronary disease$.tw.
14
coronary thrombo$.tw.
15
coronary angioplast$.tw.
16
myocard$ infarct$.tw.
17
myocard$ ischemi$.tw.
18
myocard$ ischaemi$.tw.
19
heart infarct$.tw.
20
heart disease$.tw.
21
cardiac disease$.tw.
22
acute coronary syndrome.tw.
23
cardiac inpatient$.tw.
24
cardiac patient$.tw.
25
heart patient$.tw.
26
cardiac outpatient$.tw.
27
((cardiovascular or coronary or cardiac) adj risk factor$).tw.
28
smoking cessation.tw.
29
(heart adj5 outpatient$).tw.
30
(heart adj5 inpatient$).tw.
31
or/1-30
32
((psychoeducational or psycho-educational) adj (program$ or therap$ or change$ or outcome$ or
effect$ or treatment$ or variable$ or factor$)).tw.
19
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Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
33
((psychosocial or psycho-social) adj (program$ or therap$ or change$ or outcome$ or variable$
or factor$ or change$ or effect$ or treatment$ or rehabilitation)).tw.
34
(psychological adj (distress or stress or rehabilitation or variable$ or factor$ or adaptation$ or
outcome$ or therap$ or change$ or effect$)).tw.
35
((behavio?ral or educational or psychological or psychosocial or psycho-social or
psychoeducational or psycho-educational) adj intervention$).tw.
36
(behavio?r$ adj therap$).tw.
37
(behavio?r$ adj modif$).tw.
38
psychopathology.tw.
39
autogenic training.tw.
40
counsel?ing.tw.
41
cognitive therapy.tw.
42
((health or patient) adj education).tw.
43
motivational interview$.tw.
44
group psychotherapy.tw.
45
relaxation technique$.tw.
46
(type-A adj (behavio?r$ or counsel?ing)).tw.
47
(cardiac adj (counsel?ing or nurs$)).tw.
48
telephone.tw.
49
group therapy.tw.
50
(lifestyle adj (change$ or management)).tw.
51
(self adj (management or care)).tw.
52
((stress or anxiety or distress) adj management).tw.
53
(behavio?r$ adj (change$ or program$)).tw.
54
health behavio?r$.tw.
55
social support.tw.
56
support network$.tw.
57
((structured or brief) adj (intervention or follow-up)).tw.
58
(nurse-led or nurse delivered).tw.
59
case-management.tw.
60
((psychosocial or psycho-social) adj nursing).tw.
61
liaison nurs$.tw.
62
Rehabilitation/
63
Psychotherapy/
64
Counseling/
65
Relaxation Techniques/
66
Psychotherapy, group/
67
Adaptation, psychological/
68
Patient education/
69
Cognitive therapy/
70
Behavior Therapy/
20
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Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
71
Health behavior/
72
Rehabilitation, vocational/
73
Stress, psychological/
74
Stress/pc [Prevention & Control]
75
Lifestyle/
76
Health education/
77
Health promotion/
78
Life change events/
79
Motivation/
80
Social support/
81
Social environment/
82
Self-care/
83
Sick Role/
84
Meditation/
85
Anxiety/
86
Psychopathology/
87
Autogenic Training/
88
Coronary Prone Behavior/
89
Coronary Care Nursing/
90
exp Rehabilitation, Cardiac/
91
or/32-90
92
exp Clinical Trials/
93
Clinical Trial.pt.
94
Randomi?ed controlled trial$.tw.
95
Controlled clinical trial$.tw.
96
or/92-95
97
Random assignment/
98
Random$.tw.
99
(clin$ adj25 trial$).ti,ab.
100 ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).ti,ab.
101 Placebos.sh.
102 placebo$.tw.
103 or/97-102
104 103 not 96
105 Comparative Studies/
106 Prospective Studies/
107 Follow up study.tw.
108 (control$ or prospectiv$ or volunteer$).ti,ab.
109 or/105-108
110 109 not (104 or 96)
21
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
111 96 or 104 or 110
112 111 and 91 and 31
113 limit 112 to yr="2007 - 2008"
114 from 113 keep 1-498
22
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Dickens et al., Characteristics of psychological interventions that improve depression in people with
coronary heart disease – A systematic review and meta-regression
eFigure 1 Selection of studies for inclusion in the review
6785 records identified
from database
searching
6746 records after 39
duplicates removed
6746 records screened
titles/abstracts
6462 records excluded
incl.
24 reviews
8 ongoing RCTs
284 full text articles
assessed for eligibility
220 full text articles
excluded
Not RCT (n=28)
Not CHD (n=13)
Not psychosocial
intervention (n=23)
No psychological
outcome (n=33)
Not depression (n=87)
Other (e.g. not relevant
or authors unable to
provide data n=37)
4 records included from
additional sources (fig
2)
9 records included from
additional sources (fig
3)
64 records
77 references (62
studies) included in
quantitative synthesis
(meta-analysis)
23
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Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
eTable 6: Characteristics of study populations
Study
Sample
size
Mean
age
Males
(%)
CHD
diagnosis
Appels
2005/Appels
2006 (1)
710
53.36
77.5
Ashton
1997/Ashton
1995 (2)
22
65.23
86.4
Post PCI
(stable
angina,
unstable
angina,
MI)
First
CABG
Barr Taylor
1986 (3)
210
52
100.0
Barth 2005
(57)
59
Interventi
on: 60.81
Control:
55.62
Berkman,
ENRICHD
writing
committee
2003 (4)
Blumenthal
2005 (5)
2481
61
134
63
Time since
diagnosis / acute
event when
patients
recruited to trial
2 weeks post
admission
Where
recruited
Depressed at
baseline or
depressed
subgroup
analysed?
No
Depression
assessment
Baseline mean (SD)
depression score
SCID (DSM-IV)
Intervention n=58
(16%), control n=43
(12%)
Day before CABG
Secondary
care
No
POMS depression
scale
Not reported
MI
≤ 28 days
following
admission for MI
Secondary
care
No
HAM-D
3.5
76.3
MI, CABG,
PTCA,
unstable
angina
pectoris
On admission
Secondary
Care
Yes
BDI, HADS, BRMS
56.3
MI
≤ 28 days
following MI
Secondary
care
Yes
BDI, HRSD
BDI: TG=19.04
UC=21.25
BRMS:TG=9.78
UC=8.66
HADS: TG=23.07
UC=24.58
BDI 15.7, HRSD 15.5
68.7
IHD
Not reported
Community
via adverts
No
BDI
9.4 (7.8)
24
Secondary
care
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Sample
size
Mean
age
Males
(%)
CHD
diagnosis
Time since
diagnosis / acute
event when
patients
recruited to trial
4-24 months post
acute event
Where
recruited
Brown 1993
(6)
40
60.6
72.5
MI, CABG
Burgess
1987 (7)
180
50.9
85.6
MI
Claesson
2005 (8)
198
61
0
MI, CABG,
PTCA,
angina
pectoris
de Klerk
2004 (9)
Dugmore
1999 (10)
50
56
100.0
124
Engblom
1997 (11)
FrasureSmith 1997
(12)
228
Good
prognosis
group:
52.25
Poor
prognosis
group:
59.4
54
1376
Freedland
2009 (13)
123
Depressed at
baseline or
depressed
subgroup
analysed?
Yes
Depression
assessment
Baseline mean (SD)
depression score
BDI
14.7
Immediately
following transfer
from CCU to
general ward
≥6 mos since
acute event
Secondary
care
No
ZUNG
Not reported
Community
No
Not reported
Immediately prior
to CABG
3 weeks following
MI
Secondary
care
Secondary
care
No
Psychopathological
Rating Scale Self
Affective (CPRS-SA) depression
scale
BDI-II, POMS
depression scale
Toronto Attitude
Scale - depression
98.4
First
CABG
MI
88.2
CABG
Immediately prior
to CABG
Immediately
following transfer
from CCU to
general ward
<1 year since
CABG
Secondary
care
Secondary
care
No
BDI
11.7
59.3
65.6
MI
No
BDI
8.5
CBT
61.51,
50.41
CABG
Secondary
care
Yes
DISH (DSM IV)
minor/major
depression (n/%)
-Minor depression:
CBT (n=15, 37%)
-SSM (n=12, 29%),
control (n=15, 38%)
SSM
25
Secondary
care,
community
No
BDI-II 12.3, POMS
15.8
Not reported
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Sample
size
Mean
age
Males
(%)
CHD
diagnosis
Time since
diagnosis / acute
event when
patients
recruited to trial
Where
recruited
Depressed at
baseline or
depressed
subgroup
analysed?
Depression
assessment
Baseline mean (SD)
depression score
59.9
Immediately postdischarge
Unspecified time)
post discharge
following ICD
(nr?)
Pre-first CABG
Secondary
care
Secondary
care,
community
No
WHO questionnaire
-Major depression:
CBT (n=26, 63%)
-SSM (n=30, 71%),
control (n=25, 62%)
n/r
No
HADS
Not reported
Secondary
care
No
Cardiac depression
scale
95
Shortly after
admission
Secondary
care
No
HADS
6.2
80.9
CAD, MI,
CABG,
coronary
angiograp
hy, stable
angina
Pre-CABG
Not reported
Secondary
care
No
HADS
4.7
83.9
PTCA
Immediately prior
to PTCA
Secondary
care
No
BDI
8.6
36.38
ACS
Shortly after
hospital
admission for
ACS
Secondary
care
No
CES-D
13.6
Fridlund
1991 (14)
Frizelle 2004
(15)
178
56.41
56.7
MI
22
n/r
n/r
CHD
Furze 2009
(16)
204
64.78
80.39
CHD, preCABG
Gallagher
2003 (17)
196
67.53
0
Goodman
2008 (18)
188
64.78
HofmanBang 1999
(19)
87
53
HolmesRovner 2008
(20)
525
60
26
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Sample
size
Mean
age
Males
(%)
CHD
diagnosis
Time since
diagnosis / acute
event when
patients
recruited to trial
Not reportedr
Where
recruited
Hughes
2007 (21)
70
60
56
Stable
CHD
Johnston
1999 (22)
100
55.62
65
Jones 1996
(23)
2328
n/r
Karlsson
2007 (24)
224
Koertge
2007 (25)
Depressed at
baseline or
depressed
subgroup
analysed?
No
Depression
assessment
Baseline mean (SD)
depression score
HADS
Median 2 (1,4)
MI
<72 hours post
admission to CCU
Secondary
care
No
HADS
6.7
n/r
MI
≤28 days post MI
Secondary
care
No
DSSI/sad
Median (5th, 95th)
Intervention 1 (0,8),
control 1 (0,9)
63.55
76.8
MI or
planned
CABG
Recruited at
admission for MI
or at home while
on waiting list if
planned CABG
Recruited during
hospitalisation
Secondary
care
No
HADS
Not reported
247
62.07
0
MI, PCI,
CABG
Secondary
care
No
BDI
10.93
Leserman
1989 (26)
27
67.53
66.7
Cardiac
surgery
2 days postoperatively;
Duration of
illnessexperimental
group – 4.9 (s.d.
= 5.6), control
group – 8.5 (s.d.
= 7.7)
26% <6 mo since
most recent
cardiac event;
30% 6mo-2yrs;
Secondary
care
No
POMS depression
scale
13.2
Lesperance
2007 (27)
284
58.15
75.4
CHD
Outpatients
Yes
HAM-D, BDI-II,
Inventory of
Depressive
Severity
HAM-D 29.8, BDI-II
30.3
27
Secondary
care
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Sample
size
Mean
age
Males
(%)
CHD
diagnosis
Time since
diagnosis / acute
event when
patients
recruited to trial
and 42% >2 yrs.
Where
recruited
Depressed at
baseline or
depressed
subgroup
analysed?
Depression
assessment
Baseline mean (SD)
depression score
Lewin 1992
(28)
176
55.82
71.6
MI
Within 3 days of
MI
Secondary
care
yes
HADS
4.6
Lewin 2002
(30)
142
67.21
59.9
Angina
Pectoris
>12 months since
diagnosis
Primary care
No
HADS
Not reported
Lewin 2002a
(31)
243
64
74.5
MI
Within 24 hours of
admission
Secondary
care
No
HADS
5.4
Lewin 2009
(29)
192
61.72
90.10
CHD
Upon admission
to hospital for ICD
Secondary
care
No
HADS
Not reported
Lie 2007
(32)
203
62
81.8
Pre-CABG
1-5 days post
admission for
surgery
Secondary
care
Yes
HADS
4.1
Linden 1995
(33)
41
61.5
56.1
MI
On admission to
CCU
Secondary
care
No
HADS
3
28
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Sample
size
Mean
age
Males
(%)
CHD
diagnosis
McHugh
2001 (34)
98
76.5
First
CABG
McLaughlin
2005 (35)
100
Interventi
on
median
61.1,
control
median
63.0
60.3
53.0
Merswolken
2011 (58)
62
Interventi
on: 62.5.
Michalsen
2005 (36)
Mittag 2006
(37)
Breaks
down
as: 30
in
interven
tion, 32
in
control
101
343
Time since
diagnosis / acute
event when
patients
recruited to trial
When added to
(CABG) waiting
list
Where
recruited
ACS
On admission to
CCU
Interventi
on group
76.0
Control
group:
70.0
CHD
≥3 months post
hospital discharge
59.42
77.2
CAD
59.81
81.9
Cardiac
event (MI,
PCI,
Control:
59.8
Following
coronary
angiography,
percutaneous
coronary
intervention (PCI)
or stationary
treatment for
CAD.
Following cardiac
event
29
Depressed at
baseline or
depressed
subgroup
analysed?
No
Depression
assessment
Baseline mean (SD)
depression score
HADS
Not reported
Secondary
care
Yes
HADS
7.5
2 cardiology
hospitals
Yes
HADS
Secondary
care
No
Diagnostic
Interview for
Psychiatric
Disorders on
anxiety disorders,
affective disorders,
alcohol and drug
abuse.
BDI
HADS Depression
score:
Intervention: 7.4 (3.1)
Controls: 7.6 (3.9).
Secondary
care
No
CES-D
Secondary
care
Psychiatric disorders
interview- depression
and dysthymia:
Intervention: 8 (2).
Control group: 7 (26)
9.6
Intervention men 12.2
(7.8), women 16.2
(8.0), control men
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Sample
size
Mean
age
Males
(%)
CHD
diagnosis
Time since
diagnosis / acute
event when
patients
recruited to trial
Where
recruited
Depressed at
baseline or
depressed
subgroup
analysed?
Depression
assessment
CABG)
Moore 2001
(38)
193
62.6
49.7
Pre-CABG
Murchie
2004 (39)
1343
66.2
58.2
CHD
Mutwali
2012 (59)
49
Interventi
on: 56.75
Control:
57.22
100.0
Newton
1991(40)
40
<70
Oldridge
1991 (41)
201
Oranta 2010
(60)
103
Baseline mean (SD)
depression score
13.0 (7.5), women
17.5 (10.0)
1 month after
coronary artery
bypass graft
surgery
Not reported
Secondary
care
No
POMS depression
scale
9.1
Primary care
No
HADS
Intervention n=39
(96%), control n=46
(7%)
PreCABG
Following
admission for
CABG
No.
HADS
HADS
Intervention: 5.86
(2.93)
Control: 8.24 (3.18)
72.5
MI
Following
diagnosis
On
admission to
the cardiac
surgery
departmentSecondary
care
Secondary
care
No
BDI, POMS
depression scale
BDI 8.1, POMS 6.2
52.8
88.1
MI
Upon admission
to hospital
Secondary
care
Yes
BDI
4.1
59.6
Interventi
on group:
74.5
Control
group:
67.3
Acute MI
Following
admission
Secondary
Care
Yes
BDI
Intervention group:
8.6 (6.8)
Control group: 7.7
(6.0)
30
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Sample
size
Mean
age
Males
(%)
CHD
diagnosis
Time since
diagnosis / acute
event when
patients
recruited to trial
Not reported
Where
recruited
Depressed at
baseline or
depressed
subgroup
analysed?
No
Depression
assessment
Baseline mean (SD)
depression score
PaulLabrador
2006 (42)
103
67.42
81.6
CHD
CES-D
9.3
Poortaghi
2011 (61)
80
Interventi
on: 57.05
Control:
57.78
Interventi
on group:
72.5
Control
group:
77.5
Post
CABG, MI,
percutane
ous
translumin
al
coronary
angioplast
y (PTCA)
MI, CABG,
angina
pectoris
1.5 months post
discharge from
hospital
Ambulatory
rehabilitation
centre
Yes
GHQ-28
Intervention group:
4.06 (0.25)
Control group: 6.94
(0.28)
Postlethwait
e1986 (43)
27
52.2
27
Upon admission
Secondary
care
No
Depression
adjective checklist
n/r
Scholz 2006
(44)
Schrader
2005 (45)
198
58.5
82.3
CHD
Not reported
No
CES-D
13.54
Upon admission
to cardiology unit
Yes
CES-D
Intervention
moderate/severe 35.5
(7), mild 20.3 (3),
control
moderate/severe 34.7
(6.4), mild 20.5 (3.2)
77.9
MI,
unstable
angina,
arrhythmia
, CABG,
angioplast
y
MI, CABG
Secondary
care
Primary
care,
secondary
care
669
n/r
62.0
Sebregts
2005 (46)
Seki 2003
(47)
204
55.41
No
BDI, SCID
7.6
69.68
100.0
CHD
No
ZUNG
33.7
62.51
80.9
First
CABG
At least 6 months
after major
coronary event
Awaiting coronary
bypass surgery
Secondary
care
Secondary
care
38
Shuldham
2002 (48)
356
Secondary
care
No
HADS
5.75
Not specified
31
Secondary
care,
community
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Sample
size
Mean
age
Males
(%)
CHD
diagnosis
Time since
diagnosis / acute
event when
patients
recruited to trial
Not specified
Sneed 1997
(49)
Sorlie 2007
(50)
34
63
n/r
109
58.26
88.1
ICD
recipients
Stable
angina
Depression
assessment
Baseline mean (SD)
depression score
13.7
No
POMS depression
scale
ZUNG
Southard
2003 (51)
104
62.3
75.0
CHD
Not reported
Primary
care,
secondary
care,
community
No
BDI
8.4
Stern 1983
(52)
106
<70
85.8
MI
Not specified
Secondary
care,
community
Yes
ZUNG
35.2
Thompson
1990 (53)
Trzcieniecka
-Green 1996
(54)
60
54.32
100.0
First MI
Following
admission to CCU
2 to 3 months
following
myocardial
infarction or
coronary artery
bypass
Following
admission to CCU
Secondary
care
Secondary
care
No
HADS
n/r
100
60.2
87.0
MI, CABG
No
HADS
4.5
Unden 1993
(55)
103
58
100.0
MI
Secondary
care
No
3.5
CABG surgery
within the last 8 or
9 days
Cardiac unit
in tertiary
centre
No
Combined
depression
assessment
POMS
Utriyaprasit
2010 (62)
120
Interventi
on: 62.78
Control:
63.30
70.0
CABG
surgery
Awaiting CABG
32
Where
recruited
Secondary
care
Secondary
care
Depressed at
baseline or
depressed
subgroup
analysed?
No
37.3
Scores for
“depression and
dejection” which is a
category of POMS:
Intervention: 2.93
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Vale 2003
(56)
Sample
size
792
Mean
age
58.45
Males
(%)
77.0
CHD
diagnosis
CABG,
PTCA, MI,
unstable
angina,
coronary
angiograp
hy with
planned
revascular
isation
Time since
diagnosis / acute
event when
patients
recruited to trial
Following hospital
admission
33
Where
recruited
Secondary
care
Depressed at
baseline or
depressed
subgroup
analysed?
No
Depression
assessment
Cardiac depression
score
Baseline mean (SD)
depression score
(4.64)
Control: 2.33 (3.52)
Not reported
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Abbreviations for Table 1 – Characteristics of study populations
n/r – not reported
n/a – not applicable
CBT – Cognitive behaviour therapy
SSM – Supportive stress management
CHD diagnosis:
ACS – Acute coronary syndrome
CABG – Coronary artery bypass graft
CAD – Coronary heart disease
ICD – Implantable cardioverter defibrillator
IHD – Ischemic heart disease
MI – Myocardial infarction
PCI – Percutaneous coronary intervention
PTCA – Percutaneous transluminal coronary angioplasty
Depression assessment:
BDI/BDI-II – Beck depression inventory
CES-D – Center for Epidemiological studies depression scale
DISH (DSM-IV)
DSSI/sad – Personal disturbance scale
HADS – Hospital anxiety and depression scale
HAM-D/HRSD – Hamilton rating scale for depression
POMS – Profile of mood states
SCID (DSM-IV) – Structured clinical interview for depression (Diagnostic and statistical manual version 4)
WHO questionnaire – World health organisation
ZUNG – Self assessment depression scale
34
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
eTable 7: Characteristics of the interventions
Study
Intervention
Control group
Lifestyle
Psychological
No. Sessions
Appels
2005/Appels 2006
(1)
Exhaustion
intervention study
Usual care
General
discussion
Relaxation,
miscellaneous
(health
professionals
available to answer
patients questions)
14
Ashton
1997/Ashton1995
(2)
Self hypnosis
relaxation
techniques
Usual care
n/a
Relaxation
Barr Taylor 1986
(3)
Treadmill testing
plus home
exercise training
Usual care (exercise
testing 6 months post
MI)
Exercise
n/a
Asked to
practice
hourly prior to
surgery and
as often as
possible post
operatively
23
Barth 2005
Brief additional
psychotherapeutic
treatment
Usual care
Behavior
therapy
CBT
Berkman,
ENRICHD writing
committee 2003
(4)
Cognitive
behavioural
therapy (and
antidepressant
Usual care
n/a
CBT, social support
35
Length
session
(hours)
2.00
Who delivered the
intervention?
Delivery
method
Group
face to
face
n/r
Group discussion
facilitated by
counsellors,
patients were able
to meet with a
cardiologist,
dietician, health
educator for further
information
n/r
n/r
Program nurse
4-6
0.50
Three
Psychotherapists
26
1.00
Counsellors
(trained in clinical
or counselling
psychology, clinical
Combined
individual
remote
and group
face to
face
not
explicitly
specifiedface to
face
Combined
individual
and group
face to
Combined
individual
face to
face and
remote
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Intervention
Control group
Lifestyle
Psychological
No. Sessions
Length
session
(hours)
medication)
Blumenthal 2005
(5)
Who delivered the
intervention?
Delivery
method
social work, clinical
psychiatry or
psychiatric nursing)
face
1. Supervised
aerobic
exercise
training
2. Stress
management
Behaviour therapy
Usual care
1.Exercise
2. n/a
1. n/a
2. Problem solving,
social support,
relaxation
1. 48
2.16
1. 0.35
2. 1.50
No details given
Combined
individual
and group
face to
face
Control group (acted as
control for non specific
treatment effects)
Behaviour
therapy
12
1.00
Usual care
n/a
6
n/r
One of 3 therapists
(2 clinical
psychologists, 1
psychiatrist)
Masters level nurse
practitioners
Individual
face to
face
Cardiac
rehabilitation
programme
Cognitive
behavioural stress
management
Cognitive
restructuring,
relaxation,
miscellaneous
CBT model, social
support
Usual care
General
education,
skills training
Cognitive
behavioural therapy
20
2.00
de Klerk 2004 (9)
Hypnotherapeutic
ego strengthening
Usual care
n/a
Relaxation
hypnotherapy
5
1.00
Dugmore 1999
(10)
Exercise
rehabilitation
programme
Usual care
Exercise
n/a
156
n/r
Engblom 1997
(11)
Rehabilitation
programme
Usual care (hospital
treatment group)
General
education,
skills
training,
exercise,
Miscellaneous
(anxiety and
psychological risk
management)
n/r
Total contact
time 79.5
hours
Brown 1993 (6)
Burgess 1987 (7)
Claesson 2005 (8)
36
Described as a
leader no details
about profession
given
Not clear who
delivered pre-op,
post-op using
cassette tape “the
principal authors
voice was used”
No details given
Physician,
psychologist,
physiotherapist,
occupational
therapist,
Individual
face to
face
Group
face to
face
Individual
face to
face
Individual
face to
face
Combined
individual
and group
face to
face
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Intervention
Control group
Lifestyle
Psychological
No. Sessions
Length
session
(hours)
behaviour
therapy
Who delivered the
intervention?
Delivery
method
nutritionists
Frasure-Smith
1997 (12)
Psychosocial
nursing
intervention
Usual care
Education
n/a
2
1.00
Nurses
Individual
face to
face
Freedland 2009
(13)
1. Cognitive
behavioural
therapy
2. Supportive
stress
management
Caring
rehabilitation
programme
Usual care
1. Relapse
preventi
on
2. n/a
1. CBT
2. Relaxation,
miscellaneous
12
1.00
1 of 3 therapists (2
clinical
psychologists, 1
clinical social
worker)
Individual
face to
face
Usual care
General
discussion,
exercise
Relaxation
24
2.00
Physiotherapist,
physician,
rehabilitation nurse
Frizelle 2004 (15)
Cognitive
behavioural
rehabilitation
programme
Waiting list control
Relaxation
6
2.00
Physiotherapists,
Liaison cardiac
nurse,
Electrocardiogram
(ECG) technicians
Furze 2009 (16)
HeartOp
programme
Usual care (routine
nurse counselling and
education)
General
education,
general
discussion,
exercise,
behaviour
therapy
General
education
Combined
individual
and group
face to
face
Group
face to
face
Problem solving,
relaxation
4
0.15
Nurses
Gallagher 2003
(17)
Telephone
counselling
intervention
Usual care
n/a
Miscellaneous
(support and
information tailored
to individual need)
5
0.30
Cardiac nurse
Fridlund 1991 (14)
37
Combined
individual
face to
face and
remote
Combined
individual
face to
face and
remote
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Intervention
Control group
Lifestyle
Psychological
No. Sessions
Length
session
(hours)
n/r
Who delivered the
intervention?
Delivery
method
Goodman 2008
(18)
Nurse-led support
and lifestyle
management
Usual care
General
education,
general
discussion
Miscellaneous
(counselling,
motivational
interviewing)
9
Nurses
Individual
face to
face
Hofman-Bang
1999 (19)
Residential
rehabilitation
Usual care
Relaxation
Holmes-Rovner
2008 (20)
Outpatient
telephone
coaching
Usual care (GAP
program until discharge)
Hughes 2007 (21)
Exercise
consultation and
exercise
information
Usual care (with
exercise information)
General
education,
general
discussion,
skills
training,
relapse
prevention,
exercise,
behaviour
therapy
Behaviour
therapy,
relapse
prevention
Relapse
prevention
4 week
residential
stay then 11
month
maintenance
programme
involving
regular
contact with
nurse
n/r
Residential
program (not
clear),
maintenance
program (nurse)
Combined
individual
and group
face to
face
Social support
6
0.30
Trained health
educator
Individual
remote
Problem solving,
social support
4
Consultation
0.30, phone
call 0.10
Trained researcher
Individual
face to
face and
remote
Johnston 1999
(22)
Inpatient cardiac
counselling and
rehabilitation
program
Usual care
n/a
Miscellaneous
(counselling and
rehabilitation)
Mean (SD)
5.55 (0.82)
Mean total
(SD) 3.69
hours (0.19)
One of 2 nurse
counsellors
Individual
face to
face
Jones 1996 (23)
Psychological
rehabilitation
Usual care
General
education,
general
discussion
Relaxation,
miscellaneous
(stress
management,
counselling)
7
2.00
Clinical
psychologists,
health visitors
Combined
individual
and group
face to
face
38
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Intervention
Control group
Lifestyle
Psychological
No. Sessions
Who delivered the
intervention?
Delivery
method
Physiotherapist,
cardiologist, nurse,
dietician, medical
social worker
Combined
individual
and group
face to
face
20
Length
session
(hours)
Total contact
time 76.00
(based on
timings
given) plus 5
day stay at
patient hotel
2.00
Karlsson 2007
(24)
Expanded cardiac
rehabilitation
General
education,
skills
training,
exercise
Miscellaneous
(counselling, stress
management)
52
Koertge 2007 (25)
Stress
management
intervention
Usual care (also
received physical
training,
information/counselling,
heart school, outpatient
clinic, individual
counselling)
Usual care
Miscellaneous
(stress
management)
Leserman 1989
(26)
Relaxation
response
Usual care
General
education,
general
discussion
n/a
Nurses
Group
face to
face
Relaxation
14
n/r
Nurse
n/a
Social support,
miscellaneous
(interpersonal
psychotherapy)
12
0.20
Standard care and
placebo information and
informal counselling
General
education,
exercise
9
0.10
Nurse led secondary
prevention educational
session
General
education,
behaviour
therapy
Relaxation,
miscellaneous
(stress
management, self
help for
psychological
problems)
Relaxation (tape),
miscellaneous
(angina plan
manual)
Doctoral or
masters level
clinicians
(minimum 4 years
psychotherapy
experience)
Self help and
researcher as
facilitator
Individual
face to
face
Combined
individual
face to
face and
remote
Lesperance 2007
(27)
Interpersonal
psychotherapy
(and
antidepressant
medication)
Clinical management
Lewin 1992 (28)
Self help
rehabilitation
programme
Lewin 2002 (30)
Self management
angina plan
Introductory
session, 4
telephone
calls,
relaxation
sessions
(every day but
does not
0.30
39
Practice nurse (but
not the patients
own)
Combined
individual
face to
face and
remote
Combined
individual
face to
face and
remote
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Intervention
Control group
Lifestyle
Psychological
No. Sessions
Length
session
(hours)
Who delivered the
intervention?
Delivery
method
0.30
Nurses
Combined
individual
face to
face and
remote
Combined
individual
face to
face and
remote
Individual
face to
face
Lewin 2002a (31)
Advice and
relaxation music
tapes
Usual care and patients
own choice music tape
(from a predetermined
selection)
General
education
Relaxation (tape)
specify how
long for) plus
patient
workbook and
'treatments
one day a
week'
2
Lewin 2009 (29)
ICD Plan (brief
CBT)
Usual care/waiting list
control
General
education
CBT, relaxation
4
0.15
Nurses
Lie 2007 (32)
Critical care, nurse
led educational
and psychological
support
intervention - home
based intervention
programme
Heart manual
rehabilitation
programme
Usual care
n/a
Miscellaneous
(coping strategies,
emotional support)
2
1.00
Masters prepared
critical care nurse
Usual care (advice and
information leaflets)
General
education
4
n/r
Nurses
Combined
individual
face to
face and
remote
Nurse led shared
care intervention
Usual care
General
education
Miscellaneous
(heart manual advice to exercise,
informal
counselling,
relaxation)
Miscellaneous
(intervention to
address behavioural
risk factors specific
to patient need and
15
n/r
Liaison nurse,
general practitioner
team nurse
Individual
face to
face
Linden 1995 (33)
McHugh 2001
(34)
40
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
McLaughlin 2005
(35)
Intervention
Control group
Lifestyle
Psychological
willingness to
change, otherwise
general
information/advice)
Problem solving,
miscellaneous
(counselling)
Stress Management
Relaxation, CBT,
Social Support
CBT, relaxation
No. Sessions
Length
session
(hours)
Who delivered the
intervention?
Delivery
method
6
0.30
Individual
remote
15
2.00
15
Psychiatrist, clinical
psychologist,
internist
Two clinical
psychologists and
a cardiologist
No details given
Nurses
Individual
remote
Telephone
counselling
intervention
Group-based
Psychotherapy
Usual care
n/a
Usual care
General
education
Michalsen 2005
(36)
Lifestyle/stress
management
programme
Written advice only
General
education,
skills training
Mittag 2006 (37)
Nurse managed
telephone
secondary
prevention
programme
Home recovery
information
intervention
Usual care (given
written information as
attention placebo)
n/a
Miscellaneous
(information,
counselling, stress
management)
12
Total contact
time 100
hours over 1
year
n/r
Usual care
n/a
3
0.15
Research
assistant, nurse
Individual
face to
face
Nurse led
secondary
prevention clinics
Usual care
n/a
Miscellaneous (tape
to describe the
recovery
experiences of
CABG patients)
Miscellaneous
(reviewed
symptoms and
treatment, cardiac
risk factors,
assessed lifestyle
factors and if
appropriate
behavioural change
negotiated)
6
n/r
Practice nurses,
health visitors,
district nurses)
Individual
face to
face
Merswolken
2011(58)
Moore 2001 (38)
Murchie 2004 (39)
41
Group
face-toface
Group
face to
face
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Intervention
Control group
Lifestyle
Psychological
No. Sessions
Length
session
(hours)
7.00 (total
contact time)
Who delivered the
intervention?
Delivery
method
Mutwali 2012 (59)
Home based
cardiac
rehabilitation
Usual care
n/a
14
Newton 1991(40)
Exercise
rehabilitation
programme
Usual care
General
education,
general
discussion,
skills
training,
exercise
General
education,
exercise
Authors
Face to
face and
telephone
n/a
20
1.00
Group
face to
face
CBT, social support,
relaxation,
miscellaneous
(counselling)
24
1.80
n/a
miscellaneous
psychotherapy - IPT
6
Not reported
Physiotherapists,
liaison nurse,
senior house
officer from
cardiology
department
CBT (group
leaders without
formal training in
counselling),
exercise
(cardiologist,
qualified exercise
specialists)
Psychiatric Nurse
Oldridge 1991
(41)
Exercise
conditioning and
cognitive
behavioural group
counselling
Usual care
Exercise
Oranta 2010 (60)
interpersonal
counselling
Usual care
Paul-Labrador
2006 (42)
Transcendental
meditation
Active control treatment
(health education)
n/a
Miscellaneous
(transcendental
meditation)
Intervention
lasted 16
weeks
Total contact
time 39.15
No details given
Poortaghi 2011
(61)
Home-based
cardiac
rehabilitation
Usual care
General
education,
skills
training,
n/a
12
Not reported
Nurse, nutritionist,
psychotherapist,
researcher,
community mental
42
Group
face to
face
Individual
face to
face and
over the
phone
Combined
individual
and group
face to
face
Individual
face to
face
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Intervention
Control group
Lifestyle
Psychological
No. Sessions
Length
session
(hours)
exercise
Postlethwaite1986
(43)
Stress inoculation
Scholz 2006 (44)
Self management
intervention (based
on self-regulatory
theory) to foster
maintenance of
physical activity
levels)
Psychiatry liaison
with general
practitioners
Schrader 2005
(45)
Sebregts 2005
(46)
Seki 2003 (47)
Shuldham 2002
(48)
Who delivered the
intervention?
Delivery
method
health nurse
Combined control
(attention/education and
no treatment)
Usual care (had
previously taken part in
a 3 week standard
rehab programme)
General
education,
skills training
n/a
Relaxation
2
1.30
Therapist
Miscellaneous
(planning session
and weekly diaries)
1
0.15
No details given
Usual care
n/a
Miscellaneous
(patient specific
psychiatric
telephone advice to
GPs of depressed
cardiac patients)
2
0.30
Psychiatrist,
cardiac
rehabilitation
nurse, GP
Multiple risk
modification
(stress
management and
health education)
Phase 3 cardiac
rehabilitation
programme
Usual care including and
exercise training
General
education
Relaxation
8
2.50
Psychologist and
either social worker
or pastor
Usual care
General
education,
exercise
n/a
26
1.00
Physicians,
dieticians, nurses,
exercise
physiologists
Pre-admission
patient education
Usual care
General
education,
general
discussion
n/a
1
4.00
Nurses,
physiotherapists,
doctor,
occupational
therapist,
43
Individual
face to
face
Combined
individual
face to
face and
remote
Combined
individual
face to
face with
individual
and group
remote
Group
face to
face
Combined
individual
and group
face to
face
Group
face to
face
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Intervention
Control group
Lifestyle
Psychological
No. Sessions
Length
session
(hours)
Who delivered the
intervention?
pharmacist,
dietician
Psychiatric liaison
nurse
Delivery
method
Sneed 1997 (49)
Psychosocial
nursing
intervention
Usual care (with option
to start intervention after
final assessment)
General
discussion
Miscellaneous
(counselling,
relaxation,
telephone support)
16
n/r
Sorlie 2007 (50)
Video information
combined with
individualised
information
sessions
Internet based
case management
system
Usual care including
standardised information
General
education
Miscellaneous
(information, advice)
4
1.00
Specially trained
nurses
Usual care
n/a
58
0.30
Nurse led
Stern 1983 (52)
Group counselling
Usual care
Relaxation
12
1.00
Psychiatrist, social
worker, nurse
clinician
Thompson 1990
(53)
In hospital
counselling
Usual care
General
education,
general
discussion
General
education,
general
discussion
General
education
Miscellaneous
(counselling)
4
0.30
Nurses
Individual
face to
face
TrzcienieckaGreen 1996 (54)
Group based
relaxation and
stress
management
training
Waiting list control
n/a
Social support,
relaxation,
miscellaneous
(stress
management)
10
n/r
Clinical research
psychologist
Unden 1993 (55)
Increased nurse
support
Usual care
n/a
Miscellaneous
(nurse support,
discussion of
2
0.30
Nurses
Combined
group face
to face
and
individual
remote
Individual
face to
face
Southard 2003
(51)
44
Combined
individual
and group
face to
face with
individual
remote
Combined
individual
face to
face and
remote
Combined
individual
and group
remote
Group
face to
face
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Intervention
Control group
Lifestyle
Utriyaprasit 2010
(62)
Tai Cardiac Home
Information
Programme (CHIP)
experience
Usual care plus visit
from researcher & 2
telephone calls
Education
Vale 2003 (56)
COACH program
Usual care
General
education,
behaviour
therapy
Psychological
lifestyle factors,
advice, social
support)
Relaxation,
Biofeedback
Miscellaneous
(telephone coaching
sessions)
Abbreviations for Table 2 – Characteristics of the interventions
n/r – not reported
n/a – not applicable
CBT – Cognitive behavioural therapy
MI – Myocardial infarction
GP – General practitioner
45
No. Sessions
Length
session
(hours)
Who delivered the
intervention?
Delivery
method
Not recorded
0.5 - length
of audiotape
Audiotape
5
0.20
2 dieticians, 4
nurses
Individual
face to
face &
individual
remote
Individual
remote
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
eTable 8: Quality of the studies
Study
Follow up duration
(closest to 6 months)
Sequence generation
adequate?
Allocation
concealment
adequate?
Intention to
treat analysis?
Appels 2005/Appels
2006 (1)
18 months
Yes
Yes (central
randomisation)
Yes
Ashton
1997/Ashton1995 (2)
5 days
Yes
No
No
Blinding of
outcome
assessment
Yes
Yes
Unclear
Barr Taylor 1986 (3)
26 weeks
No
No
No
Yes
Barth 2005
Berkman, ENRICHD
writing committee
2003 (4)
6 weeks
Yes
No
Yes
Yes (central
randomisation)
Yes
No
Yes
6 months
Blumenthal 2005 (5)
16 weeks
Yes
Partly (used envelopes
described as sealed or
numbered or opaque)
Brown 1993 (6)
3 months
No
No
Burgess 1987 (7)
3 months
No
12 months
No
1.5 months
No
Yes (central
randomisation)
Partly (used envelopes
described as sealed or
numbered or opaque)
Claesson 2005 (8)
de Klerk 2004 (9)
Yes
No
46
Yes
Yes
No
Unclear
Unclear
No
No
No
Unclear
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Follow up duration
(closest to 6 months)
Sequence generation
adequate?
Allocation
concealment
adequate?
Intention to
treat analysis?
Dugmore 1999 (10)
8 months
No
No
No
Blinding of
outcome
assessment
No
Unclear
Engblom 1997 (11)
8 months
No
Frasure-Smith 1997
(12)
12 months
No
No
Partly (used envelopes
described as sealed or
numbered or opaque)
Partly (used envelopes
described as sealed or
numbered or opaque)
6 months
Yes
Freedland 2009 (13)
Fridlund 1991 (14)
6 months
3 months
Frizelle 2004 (15)
2 months
Furze 2009 (16)
Gallagher 2003 (17)
3 months
No
Yes
Yes
Yes
Yes
No
No
No
No
No
No
Yes
Yes (central
randomisation)
Yes
No
No
No
Unclear
Unclear
Yes
Yes
Unclear
Goodman 2008 (18)
3 months
Yes
Yes (central
randomisation)
Yes
Hofman-Bang 1999
(19)
12 months
No
No
No
No
No
No
Yes
Yes (sealed, numbered
and opaque envelopes)
No
Holmes-Rovner 2008
(20)
8 months
6 months
Hughes 2007 (21)
47
No
Yes
Unclear
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Follow up duration
(closest to 6 months)
6 months
Johnston 1999 (22)
Jones 1996 (23)
Karlsson 2007 (24)
6 months
12 months
Sequence generation
adequate?
Allocation
concealment
adequate?
Intention to
treat analysis?
No
No
No
No
No
Yes
No
Partly (used envelopes
described as sealed or
numbered or opaque)
Yes
No
Koertge 2007 (25)
12 months
Yes
Partly (used envelopes
described as sealed or
numbered or opaque)
Leserman 1989 (26)
Days after surgery
No
No
Yes
Yes (used envelopes
described as sealed,
numbered and opaque)
Blinding of
outcome
assessment
Yes
Yes
No
No
No
No
Yes
Lesperance 2007
(27)
3 months
Yes
No
Lewin 1992 (28)
6 months
No
No
No
Yes
No
Yes
Yes
No
6 months
No
Lewin 2009 (29)
Lewin 2002 (30)
6 months
Yes
Yes (central
randomisation)
Lewin 2002 (31)
6 months
No
No
unclear
Yes
48
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Follow up duration
(closest to 6 months)
Sequence generation
adequate?
Lie 2007 (32)
6 months
Yes
Allocation
concealment
adequate?
Partly (used envelopes
described as sealed or
numbered or opaque)
Intention to
treat analysis?
Blinding of
outcome
assessment
No
No
No
Linden 1995 (33)
1.5 months
No
No
No
McHugh 2001 (34)
8 months
No
No
No
McLaughlin 2005 (35)
Merswolken 2011
(58)
6 months
Yes
No
Yes
6 months
Yes
No
Yes
Michalsen 2005 (36)
12 months
Yes
Yes (central
randomisation)
No
No
No
Yes
unclear
unclear
No
Mittag 2006 (37)
12 months
Yes
Yes (central
randomisation)
Moore 2001 (38)
1 month
Yes
Partly (used envelopes
described as sealed or
numbered or opaque)
No
Murchie 2004 (39)
12 months
Yes
No
Yes
No
No
Unclear
Mutwalli 2012 (59)
6 months
No
No
No
Newton 1991(40)
10 weeks
No
No
No
Oldridge 1991 (41)
8 months
No
No
No
49
No
No
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Follow up duration
(closest to 6 months)
Sequence generation
adequate?
Allocation
concealment
adequate?
Intention to
treat analysis?
Oranta 2010 (60)
18 months
No
No
Yes
Paul-Labrador 2006
(42)
4 months
Yes
No
No
Poortaghi 2011 (61)
2 months
No
No
No
Postlethwaite1986
(43)
0.5 months
No
No
No
Scholz 2006 (44)
12 months
No
No
No
No
Yes (central
randomisation)
Yes
Blinding of
outcome
assessment
No
Yes
No
No
No
Schrader 2005 (45)
12 months
No
Yes
Yes
Sebregts 2005 (46)
9 months
No
Partly (used envelopes
described as sealed or
numbered or opaque)
Seki 2003 (47)
6 months
No
No
No
Shuldham 2002 (48)
6 months
Yes
No
Yes
Sneed 1997 (49)
4 months
No
Partly (used envelopes
described as sealed or
numbered or opaque)
No
No
Yes (used envelopes
described as sealed,
numbered and opaque)
Unclear
Sorlie 2007 (50)
6 months
50
Yes
No
No
Yes
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary heart disease – A systematic review and metaregression
Study
Follow up duration
(closest to 6 months)
Sequence generation
adequate?
Allocation
concealment
adequate?
Intention to
treat analysis?
Southard 2003 (51)
6 months
Yes
No
No
Stern 1983 (52)
6 months
No
No
No
Thompson 1990 (53)
6 months
No
No
No
Blinding of
outcome
assessment
No
No
No
No
Trzcieniecka-Green
1996 (54)
2.5 months
No
No
No
Unden 1993 (55)
2 months
No
Partly (used envelopes
described as sealed or
numbered or opaque)
No
Utriyaprasit 2010 (62)
1 month
Yes
No
No
Unclear
unclear
unclear
Vale 2003 (56)
6 months
Yes (central
randomisation)
Yes
51
Yes
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary
heart disease – A systematic review and meta-regression
eFigure 2 Funnel plot including imputed values from Duval and Tweedie’s Trim and Fill
procedure.
Funnel Plot of Standard Error by Std diff in means
0.0
0.1
Standard Error
0.2
0.3
0.4
0.5
-2.0
-1.5
-1.0
-0.5
0.0
0.5
Std diff in means
52
1.0
1.5
2.0
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary
heart disease – A systematic review and meta-regression
eTable 9 Effects of individual treatment components from studies recruiting depressed
subjects
Treatment
n
SMD
P
General education
2
0.52
0.004
General discussion
1
0.52
0.06
Skills training
0
Exercise
2
0.25
0.26
Behaviour therapy
2
0.44
0.04
Relapse prevention
1
0.30
0.27
Problem solving
1
0.24
0.29
CBT
5
0.29
<0.001
Increase social support
3
0.10
0.48
Relaxation
5
0.30
0.03
Biofeedback
0
53
Supplemental Digital Content 1 for Psychosomatic Medicine
Dickens et al., Characteristics of psychological interventions that improve depression in people with coronary
heart disease – A systematic review and meta-regression
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