Cognitive Behavior Therapy Improves Depression in Heart Failure Patients Interview with:Dr-Ken-Freedland
Kenneth E. Freedland, PhD

Professor of Psychiatry and Psychology
Washington University School of Medicine
St. Louis, Missouri

Medical Research: What is the background for this study? What are the main findings?

Dr. Freedland: Major depression is a common problem in patients with heart failure, and it makes heart failure self-care tasks such as daily weight checks and compliance with dietary restrictions more difficult for these them.  Unfortunately, recent clinical trials have shown that both depression and inadequate self-care can be hard to treat in patients with heart failure.

Cognitive behavior therapy (CBT) is often used to treat depression in otherwise healthy individuals, but it hasn’t been tested in patients with heart failure. We added a self-care component to the standard CBT treatment protocol and conducted a clinical trial to determine whether it is effective both for depression and for self-care.  We randomized 158 heart failure patients to  cognitive behavior therapy or to usual care, and both groups received heart failure education.  About 1/3 of the patients in both groups were also taking antidepressant medications. The intervention was effective for depression, with remission rates of 51% in the cognitive behavior therapy group compared to only 20% in the usual care group.  However, it was not effective for heart failure self-care.

Medical Research: What should clinicians and patients take away from your report?

Dr. Freedland: Cognitive behavior therapy can help patients with heart failure overcome major depression, whether or not they are also taking antidepressants.  However,Cognitive behavior therapy does not appear to add much to intensive heart failure education in terms of helping patients improve their self-care.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Freedland: An effective intervention for inadequate heart failure self-care is still needed, and the need is especially clear for depressed patients. We have already started working on the development of an alternative approach, and we hope to be able to test it in a future trial.


[wysija_form id=”5″] is not a forum for the exchange of personal medical information, advice or the promotion of self-destructive behavior (e.g., eating disorders, suicide). While you may freely discuss your troubles, you should not look to the Website for information or advice on such topics. Instead, we recommend that you talk in person with a trusted medical professional.

The information on is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

[wysija_form id=”5″]

Kenneth E. Freedland, PhD (2015). Cognitive Behavior Therapy Improves Depression in Heart Failure Patients 

Last Updated on September 28, 2015 by Marie Benz MD FAAD