Cardiovascular disease and depression: the potential of an integrated psychological treatment approach

Objective: Integrated psychological treatments addressing depression and other comorbidities together have the potential for developing better management skills for both conditions. Such programs have been successfully used in a number of populations to date including depression and alcohol and other drug use. There is emerging evidence for an additional benefit of integrated psychological treatments for lifestyle behaviours not specifically targeted by the treatment program. This study aimed to complete a 5-year follow up of initial participants across two clinical trials of integrated versus non-integrated treatments for depression and alcohol use problems to determine the long terms benefits of both the targeted and non-targeted behaviours. In doing this, and adding a CVD risk assessment, we aimed to compare the CVD risk factors for those who had completed the original treatment program (targeting depression and alcohol/cannabis use) and those who did not complete. Method: Participants completed a 30-45 minute telephone assessment. Of the 558 original participants in the treatment trials, 66 completed 60-month follow-up assessments. This sample was divided into “treatment completers” (those who attended their full complement of treatment session in the original study) and “non-completers”. Results: Treatment completers halved their cigarette consumption over time, whereas non-completers increased their tobacco use over time. This is despite tobacco not being specifically targeted by the original treatment programs. There were no significant differences between treatment completers and non-completers for CVD risk factors at 60-month follow-up, with the exception of tobacco use. At 60-months, the treatment non-completers smoked twice as many cigarettes as the treatment completers. Smoking is a leading risk factor for CVD, and is the leading preventable cause of morbidity. Conclusions: The SHADE and DAISI treatment programs were successful in reducing smoking behaviour, which suggests that the program has merit in reducing key CVD risk factors. Future studies should look at modifying the program to focus on increasing fruit and vegetable intake as well as physical activity to provide a more comprehensive CVD package.