Depression predicts failure to complete phase-II cardiac rehabilitation

Reduced adherence to medical treatment regimens may help to explain the higher risk of mortality among depressed cardiac patients. Participation in cardiac rehabilitation is a highly recommended part of the medical treatment regimen for cardiac patients. This study examined if elevated depressive symptomology, as measured by the Beck Depression Inventory (BDI), predicted failure to complete a 12-week phase II cardiac rehabilitation program for 600 patients. Logistic regression analysis showed that patients with elevated levels of depressive symptomology (BDI scores >= 10) were 2.2 times less likely to complete cardiac rehabilitation compared to patients without depression (BDI < 10), after controlling for age, gender, body mass index, and employment. Somatic symptoms predicted non-completion due to medical reasons, whereas younger age predicted failure to complete cardiac rehabilitation due to non-medical reasons. Given the difficulty of reducing mortality by treating depression directly, interventions targeting behavior change to improve medical treatment adherence might be an effective complementary strategy.