Number of group psychotherapy sessions predicts inflammation changes in patients with coronary artery disease and comorbid depression.

OBJECTIVE

Inflammation contributes to the bidirectional relationship between depression and coronary artery disease (CAD). However, the impact of group psychotherapy on inflammatory levels in CAD patients with comorbid depression has not been elucidated.

METHODS

A total of 337 patients (average age 59.2 years ±9.4, 80.4% male) from the SPIRR-CAD trial provided results of questionnaires and inflammatory data at baseline (T0) and the 18-month follow-up (T3) of a group psychotherapy program, with a maximum of 25 sessions vs. usual care.

RESULTS

At baseline, inflammatory parameters were elevated for high-sensitivity C-reactive protein (hsCRP) in 41.2%, tumor necrosis factor-α (TNF-α) in 33.2% and interleukin-6 (IL-6) in 21.1% of all patients. From T0 to T3, prevalences of elevated hsCRP (p = .027), TNF-α (p = .013) and depression scores (measured with the Hamilton Depression Rating-Scale; (p = .002) significantly decreased in all patients. Additionally, an inflammatory factors score (IFS), calculated from the inflammatory parameters showed a significant decrease between T0 and T3 (p = .046) in all patients. A blockwise multivariate logistic regression analysis revealed a 4.59-fold higher chance of IFS reduction (or stable low values) for patients with a higher number (10-25) of group psychotherapy sessions (OR = 4.59, 95% CI: 1.39-15.1, p = .012) compared to patients with 1-9 sessions, even after adjusting for comorbidities or pharmacological antidepressant treatment.

CONCLUSION

This analysis demonstrates a significant impact of group psychotherapy sessions on IFS changes in CAD patients with persistently elevated depression scores. Beyond the influence of the absence of diabetes mellitus, a higher number of group psychotherapy sessions reduces the risk of inflammatory burden.