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Aust N Z J Psychiatry. 2009 Dec;43(12):1171-7. doi: 10.3109/00048670903270415.

BraveHeart begins: pilot results of group cognitive behaviour therapy for depression and anxiety in cardiac patients.

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  • 1Liaison Psychiatry Department, John Hunter Hospital, Hunter Region Mail Centre, NSW 2310, Australia.



In a general medical hospital with limited mental health resources, a clinical need arose for an effective treatment for depression and anxiety symptoms in cardiac rehabilitation patients.


A total of 628 cardiac rehabilitation outpatients at a tertiary care centre were screened with the Hospital Anxiety and Depression Scale at week 4 of their programme, and 182 of 558 responders (33%) scored > or =8 on the Depression and/or Anxiety subscales. A 6 week group cognitive behaviour therapy programme was developed to assist these identified patients. The resulting programme, BraveHeart, was piloted on 39 patients still experiencing significant symptoms of depression or anxiety at the end of rehabilitation. Patients were assessed at baseline, after treatment, 1 and 6 months after treatment using the Hospital Anxiety and Depression Scale and the Beck Depression Inventory-II.


Significant improvement in levels of depression and anxiety symptoms occurred from baseline to post-treatment assessment, and this change was maintained at 6 months, with moderate-strong effect sizes. Feedback from the group members was positive.


A specialized group treatment programme for cardiac patients with existing depression and anxiety was created that resulted in significant reductions in symptoms.

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