Mindfulness-based stress reduction for patients with coronary heart disease and bipolar disorder: An 8-week comparative study.

Coronary heart disease (CHD) often coexists with mood disorders (MDs), but research on comorbidity predictors and interventions remains limited. This two‑phase mixed‑methods study enrolled 390 CHD patients diagnosed by coronary angiography. Mood disorders were screened using the HAMD (≥7) and confirmed via DSM‑5 psychiatric evaluation. In the observational phase, 219 CHD patients with MDs and 171 without were compared; 56% had a mood disorder, including 34 with bipolar disorder (BD). The BD group showed a significantly higher LF/HF ratio (2.03 ± 0.38, P = 0.037), indicating autonomic dysfunction. In the intervention phase, 34 BD patients were randomized to 8‑week MBSR (n = 17) or treatment as usual (TAU; n = 17). Compared with TAU, MBSR significantly reduced anxiety (HAMA: 4.31 vs. 7.69, p = 0.010) and improved autonomic function (LF/HF: 1.49 vs. 1.82, p = 0.002). Cardiac function showed no significant between‑group difference, though NYHA class improvement tended to be higher in the MBSR group. Mood disorders, especially BD with autonomic impairment, are highly prevalent in CHD patients. MBSR is a promising intervention for psychological and autonomic improvement and may be integrated into cardiac rehabilitation.