A recent study has found that patients suffering from mental illness like depression, anxiety or stress are more likely to drop out of cardiac rehabilitation.
"Heart patients living with depression are more likely to feel despondent and hopeless, which reduces their ability to manage their symptoms," said study author Angela Rao of the University of Technology Sydney, Australia.
"They may minimise successes and exaggerate failures, thereby reducing their motivation to exercise and complete a cardiac rehabilitation programme."
"Anxiety may lead to fear of another cardiac event and stop people from being active," she continued in the study published in the journal - Preventive Cardiology -- "Depression and anxiety can also impair the ability to retain new information needed to make health-related behaviour changes."
After a heart attack or procedure to open blocked arteries, patients should be supported to quit smoking, take up exercise, improve their diet, reduce stress, and control blood pressure and cholesterol -- this is achieved through cardiac rehabilitation.
This retrospective study found that patients with moderate symptoms of depression (24 per cent versus 13 per cent), anxiety (32 per cent versus 23 per cent) or stress (18 per cent versus 10 per cent) were significantly more likely to quit cardiac rehabilitation compared to those with no or mild symptoms.
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"Depression can dampen positive intentions to exercise even when receiving support from health professionals and being aware of the benefits," said Rao. "People with anxiety may underestimate their abilities -- for example to walk on a treadmill during a rehabilitation class."
Depression, anxiety, and stress were related, with one increasing the likelihood of the other. Patients with anxiety or stress were more than four times more likely to be depressed than those without.
"These relationships were independent of age, sex, clinical characteristics, medication use and quality of life," said Rao.
She urged clinicians to screen for depression and anxiety at the start and end of rehabilitation to identify those needing extra help.
Stress management, cognitive behavioural therapies, meditation, and mindfulness can be included to improve mental health and raise participation. Patients should be asked if they wish to be referred for additional psychological assistance.