Department of Psychology, University of Paris Nanterre, Nanterre, France.
Department of Kinesiology, Laboratory of Pathophysiology of EXercise (LPEX), University of Montreal, Montreal, Canada.
Disabil Rehabil. 2020 Feb;42(3):378-384. doi: 10.1080/09638288.2018.1499824. Epub 2018 Oct 9.
Cardiovascular diseases represent the main cause of death in the world. Rehabilitation through exercise is more and more used in cardiac patients. Given that these patients suffer from depressive symptoms, the risk of having recurrent cardiovascular problems increases. Thus, the aim of this study is to identify the effects of a rehabilitation program on the physiological and psychological parameters; with a particular attention on the depression scores between the scales. Twenty-eight cardiac patients participated in this study during a cardiovascular rehabilitation program. They are tested at their entry and at their exit with an evaluation of their physical fitness on an electromagnetic cycle ergometer and by four depression scales (Beck Depression Inventory, Hospital Anxiety and Depression Scale (HADS), Center for Epidemiologic Studies - Depression and Geriatric Depression Screening). We observe that 21.4-50% of these patients have depressive symptoms, according to depression scales. The women have depression scores significantly higher than the men. The rehabilitation program improves their maximal oxygen consumption and their maximal aerobic power. At the end of the rehabilitation program, our analysis identifies a significant decrease in the depression score for the HADS. Regardless of the physical deconditioning level and of the improvement of the maximal oxygen consumption, our results show an effect of the rehabilitation program on the depression scores. No correlation between the physical deconditioning and the different depression scores is observed. This study shows the importance of measuring depression and its severity to improve the care of patients. Our findings show that between 21.4% and 50% of patients have depressive symptoms which challenges the categorical approach of the self-report depression scales.Implications for rehabilitationDepression and cardiovascular diseases have an impact on the patients' physical fitness.The rehabilitation program, primarily based around exercise, reduces depressive symptoms.As soon as cardiovascular diseases patients enter in a rehabilitation program, the depression should be measured by a psychologist.Taking into account the depressive symptoms of the patients as soon as their cardiac event occurs makes it possible to improve the care of patients.
心血管疾病是世界上主要的死亡原因。运动康复在心脏病人中越来越多地被使用。鉴于这些患者患有抑郁症状，他们再次发生心血管问题的风险增加。因此，本研究的目的是确定康复计划对生理和心理参数的影响；特别关注抑郁评分量表之间的差异。
二十八名心脏病人参加了这项心血管康复计划。他们在进入和退出时接受测试，通过电磁式自行车测力计评估他们的身体适应性，以及通过四个抑郁量表（贝克抑郁量表、医院焦虑和抑郁量表（HADS）、流行病学研究中心-抑郁和老年抑郁筛查）评估他们的抑郁程度。
我们观察到，根据抑郁量表，这些患者中有 21.4-50%的人有抑郁症状。女性的抑郁评分明显高于男性。康复计划提高了他们的最大耗氧量和最大有氧能力。在康复计划结束时，我们的分析表明 HADS 的抑郁评分显著下降。无论身体适应不良的程度和最大耗氧量的改善如何，我们的结果表明康复计划对抑郁评分有影响。在身体适应不良和不同的抑郁评分之间没有观察到相关性。
这项研究表明，测量抑郁及其严重程度对改善患者的护理非常重要。我们的研究结果表明，21.4%至 50%的患者有抑郁症状，这对自报告抑郁量表的分类方法提出了挑战。
康复意义
抑郁和心血管疾病对患者的身体健康有影响。
康复计划主要以运动为基础，可以减轻抑郁症状。
一旦心血管疾病患者进入康复计划，就应由心理学家测量抑郁。
一旦发生心脏事件，就考虑患者的抑郁症状，可以改善患者的护理。
