Home-based Deep Breathing for Depression in Patients with Coronary Heart Disease: a Randomised Controlled Trial

Objectives: The primary aim of this study was to examine the effect of a home-based deep-breathing training programme on depressive symptoms as compared with a control condition (i.e., weekly telephone support) in patients with coronary heart disease (CHD).

Design: This efficacy trial used a randomised controlled, parallel group design.

Participants And Methods: A total of 62 CHD patients with a Beck Depression Inventory-II (BDI-II) >10 were randomised to receive either home-based deep-breathing training (experimental group, n=28) or weekly telephone support (control group, n=34). Both participants and data assessors were blinded to the study hypothesis. The primary outcome measure was the change in the self-reported depressive symptom severity, measured by the BDI-II. The secondary outcome was the change in the Patient Health Questionnaure-9 (PHQ-9)-assessed depressive symptom severity. Depressive symptoms were assessed at baseline and post-test in both groups. For the experimental group, depressive symptoms were also assessed at the end of the first 2 weeks of training.

Results: The post-test BDI-II and PHQ-9 were significantly lower in the experimental group than in the control group (p<0.001 and p<0.001, respectively). The decreases in BDI-II, from baseline, at post-test were significantly greater in the experimental group as compared with the control group (95% confidence interval (CI): -12.554 to -5.408, p<0.001). Similarly, the pre-test-to-post-test change in PHQ-9 scores was significantly greater in the experimental group as compared with the control group (95% CI: -5.59 to -0.092, p=0.007). Examining the changes in BDI-II and PHQ-9 within the experimental group by the repeated-measures analysis of variance (ANOVA) revealed that both measures of depressive symptoms decreased significantly over time (both p<0.001). The percentage of participants with a BDI-II >or=17 decreased over time from 28.6% at baseline, and 17.9% during treatment, to 10.7% post-test.

Conclusions: Home-based deep-breathing training is effective in reducing depressive symptoms as compared with telephone support in patients with CHD.