“The head-heart connection should be on everyone’s radar. It’s not just being unhappy. It’s having biochemical changes that predispose people to have other health problems, including heart problems.”
– Barry Jacobs, Director of Behavioral Sciences Crozer-Keystone Family Medicine Residency Program
Heart disease is the leading global cause of death, associated with significant morbidity and escalating health care costs. The relationship between cardiac health and depression reached a new level of understanding in 2014 when the American Heart Association announced that depression is a risk factor for adverse medical outcomes in patients with acute coronary syndrome. Despite this announcement, the relationship between depression and cardiac health remains complex. Some studies show that cardiac events precede depression, while others show that depression increased the risk for cardiac mortality—even in subjects without prior heart disease—or that patients with depression were 6 times more likely to die within 6 months of a cardiac event. Several studies have found peer support to be of value to cardiac patients, and given the long history of peer support’s success with depression and other behavioral issues it should not be surprising. One study found that among sufferers of cardiovascular disease an intensive 40-hour group-based CBT program decreased the risk of recurrent cardiovascular disease and acute myocardial infarction. Another study, targeting unpartnered older adults, found that a peer advisor could encourage participation in cardiac rehabilitation programs, thereby leading to fewer rehospitalizations. And peer support has been found to be viable and potentially sustainable during transitional life events such as recovery from cardiac surgery. Other psychosocial factors are also considered to contribute independently to the risk of coronary heart disease. Like depression, they may also result from the onset of a cardiac event, and—like depression—they have a long track record of successful treatment in a peer support group setting. As healthcare integration proceeds, addressing factors such as severe anxiety, chronic stress, social isolation, emotional dysregulation, and others increasingly will be seen as an essential part of a comprehensive treatment plan. Online support groups from PSS are ideally suited to post-cardiac event treatment. Attendees don’t need to be physically present to participate actively in a group, so treatment can begin as soon as the patient is able. Travel is unnecessary, so participants can attend more regularly (and be more consistently monitored). With no need to arrange for meeting rooms, security, facilitators, and so on, creating a new group can be fast and easy, and a group can be shared among multiple programs for additional cost reduction. Evidence-based content is stored online, and can be presented during meetings or provided to participants on demand. PSS support groups are effective. Participants in our long-running depression group report a 69% drop in hospital readmission, and a 33% improvement in the level of depression. Make peer support groups from PSS a part of your post-cardiac treatment program.