Journal of Behavioral Medicine

, Volume 31, Issue 5, pp 421–431 | Cite as

Depression predicts failure to complete phase-II cardiac rehabilitation

  • Elizabeth Casey
  • Joel W. Hughes
  • Donna Waechter
  • Richard Josephson
  • James Rosneck


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.


Cardiac rehabilitation Depression Medical adherence Cardiovascular disease 


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Elizabeth Casey
    • 1
  • Joel W. Hughes
    • 1
    • 2
  • Donna Waechter
    • 2
  • Richard Josephson
    • 2
    • 3
  • James Rosneck
    • 2
  1. 1.Department of PsychologyKent State UniversityKentUSA
  2. 2.Summa Health SystemAkronUSA
  3. 3.Case Western Reserve University School of MedicineClevelandUSA

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