Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of General Psychiatry
Published in: Annals of General Psychiatry 1/2020

01-12-2020 | Mood Disorders | Primary research

A pilot randomized controlled trial to assess the effect of Islamic spiritual intervention and of breathing technique with heart rate variability feedback on anxiety, depression and psycho-physiologic coherence in patients after coronary artery bypass surgery

Authors: Mohiadin Amjadian, Hadi Bahrami Ehsan, Kaivan Saboni, Siamak Vahedi, Reza Rostami, Daem Roshani

Published in: Annals of General Psychiatry | Issue 1/2020

Login to get access

Abstract

Background

This study investigated the effects of Islamic religious and breathing techniques with heart rate variability (HRV) biofeedback therapies on HRV and psycho-physiologic coherence (resonance frequency), depression and anxiety in coronary artery bypass graft surgery (CABG) patients.

Methods

Sixty CABG patients were chosen and randomly assigned to religious, breathing techniques and control groups. The experimental groups received 8  weeks of treatments; a 2-h session with home works in each week. The control group received only their normal hospital interventions. The groups’ depression, anxiety, HRV and psycho-physiologic coherence levels were assessed before and after the interventions by DASS-21 for depression and anxiety, and em-wave desktop software for HRV and psycho-physiologic coherence. The data were analyzed using ANCOVA with Bonferroni Comparison test and descriptive tests in SPSS software.

Results

The findings showed that there were significant differences in psycho-physiologic coherence (HRV), depression and anxiety scores among the three groups in the post-tests. In fact, depression and anxiety were reduced more in the religious group, while psycho-physiologic coherence raised more in the breathing with the HRV feedback group.

Conclusion

The results showed that both Islamic religious and breathing techniques with HRV biofeedback therapies can be used in rehabilitation programs for CABG patients in clinics and hospitals.
Literature
1.
Williams MA. American association of cardiovascular and pulmonary rehabilitation. In: Guideline for cardiac rehabilitation and secondary prevention programs, 4th Ed. Champaign: Human Kinetics; 2004.
2.
3.
Deyrimenjian M, Karam N, Salemeh P. Preoperative patient education for opens heart patients: a source of anxiety? Patient Educ Couns. 2006;62(1):111–21.
4.
Hazavei MM, Sabzemkan L, Hasanzadeh A, Rabei K. Impact of educational intervention based on the question of depression, and quality of life for patients with coronary artery replacement surgery. J Qazvin Univ Med Sci. 2008;12(2):32–41.
5.
Brotman DJ, Golden SH, Wittstien IS. The cardiovascular toll of stress. Lancet. 2007;370:1089–100.PubMed
6.
Rosengren A, Hawken S, Ounpuu S, et al. Association of psychological risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (THE INTERHEART STUDY): case control study. Lancet. 2004;364:953–62.PubMed
7.
Lichtman GH, Bigger GT, Blumenthal G. Depression and coronary heart disease. Recommendations for screening, referral, and treatment. A Science advisory From then American Heart Association Prevention Committee Of the Council on Cardiovascular Nursing, Council on Epidemiology and Outcomes Research. Circulation. 2008;118:1768–75.PubMed
8.
Roest AM, Martens EJ, Jonge P, Denollet J. Anxiety and risk of incident coronary heart disease; a meta-analysis. J Am Coll Cardiol. 2010;56(1):38–46.PubMed
9.
Hofer S, Benzer W, Alber H, Ruttmann E, Kopp M, Schussler G. Determinants of health-related quality of life in coronary artery disease patients: a prospective study generating a structural equation model. Psychosomatic. 2005;46(3):212–23.
10.
Frenneaux MP. Autonomic changes in patients with heart failure and in post- myocardial infarction patients. Heart. 2004;9(11):1248–55.
11.
Glassman AH, Shapiro PA. Depression and the course of coronary artery disease. Am J Psychiatry. 1998;155(1):4–11.PubMed
12.
Leung YW, Flora DB, Gravely S, Irvine J, Carney RM, Grace SL. The impact of premorbid and post morbid depression onset on mortality and cardiac morbidity among patients with coronary heart disease, Meta analysis. Psychosomatic Med. 2012;74(8):786–801.
13.
14.
Frasure-Smith N, Lespérnce F. Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Arch Gen Psychiatry. 2008;65(1):62–71.PubMed
15.
Shen BJ, Avivi YE, Todaro JF, Spiro A, Laurenceau JP, Ward KD, et al. Anxiety characteristics independently and prospectively predict myocardial infarction in men: the unique contribution of anxiety among psychologic factors. J Am CollCardiol. 2008;51:113–9.
16.
Moser DK, Dracup K, Doering L, Evangelista L, Zambroski CH, Chung ML, et al. Comparison of prevalence of symptoms of depression, anxiety, and hostility in elderly patients with heart failure, myocardial infarction, and a coronary artery bypass graft. Heart Lung. 2010;39(5):378–85.PubMedPubMedCentral
17.
Konstam V, Moser DK, De Jong MJ. Depression and anxiety in heart failure. J Card Fail. 2005;11(6):455–63.PubMed
18.
Krannich JHA, Weyers P, Lueger S, Herzog M, Bohrer T, Elert O. Presence of depressionand anxiety before and after coronary artery bypass graft surgery and their relationship to age. BMC Psychiatry. 2007;7(47):1–6.
19.
Komorovsky R, Desideri A, Rozbowsky P, Sabbadin D, Celegon L, Gregori D. Quality of life and behavioral compliance in cardiac rehabilitation patients: a longitudinal survey. Int J Nurs Stud. 2008;45(7):979–85.PubMed
20.
Khosofi H, Monirpoor N, Birashk B, Paighambari M, King DE, Mainous AG 3rd, Pearson WS. C-reactive protein, diabetes, and attendance at religious services. Diabetes Care. 2002;25(7):1172–6.
21.
Hanifi N, Bahraminezhad N, Mirzaee T, Ahmadi F, Khani M, Taran L. The effect of orientation program on stress, anxiety and depression of patients undergoing coronary angiography. Iran J Nurs Res. 2012;25:1–8.
22.
Basmpoor S. Impact of preoperative education on anxiety of patients undergoing open heart surgery. Payesh. 2005;3(2):139–44 [In Persian].
23.
Bailey L. Strategies for decreasing patient anxiety in the perioperative setting. AORN J. 2010;92(4):445–60.PubMed
24.
Kronish IM, Rieckmann N, Halm EA, Shimbo D, Vorchheimer D, Haas DC, Davidson KW. Persistent depression affects adherence to secondary prevention behaviors after acute coronary syndromes. J Gen Intern Med. 2006;21:1178–83.PubMedPubMedCentral
25.
Bautista LE, Vera-Cala LM, Colombo C, Smith P. Symptoms of depression and anxiety and adherence to antihypertensive medication. Am J Hypertens. 2012;25:505–11.PubMedPubMedCentral
26.
Slavich GM, Irwin MR. From stress to inflammation and major depressive disorder: a social signal transduction theory of depression. Psychol Bull. 2014;140:774–815.PubMedPubMedCentral
27.
Sanchez-Gonzalez MA, May RW, Koutnik AP, Kabbaj M, Fincham FD. Sympathetic vasomotor tone is associated with depressive symptoms in young females: a potential link between depression and cardiovascular disease. Am J Hypertens. 2013;26:1389–97.PubMed
28.
Rieckmann N, Kronish IM, Shapiro PA, Whang W, Davidson KW. Serotonin reuptake inhibitor use, depression, and long-term outcomes after an acute coronary syndrome: a prospective cohort study. JAMA Intern Med. 2013;173:1150–1.PubMedPubMedCentral
29.
Strine TW, Chapman DP, Kobau R, Balluz L. Associations of self-reported anxiety symptoms with health-related quality of life and health behaviors. Soc Psychiatry Psychiatric Epidemiol. 2005;40:432–8.
30.
Antonogeorgos G, Panagiotakos DB, Pitsavos C, Papageorgiou C, Chrysohoou C, Papadimitriou GN, Stefanadis C. Understanding the role of depression and anxiety on cardiovascular disease risk, using structural equation modeling; the mediating effect of the Mediterranean diet and physical activity: the ATTICA study. Ann Epidemiol. 2012;22:630–7.PubMed
31.
Cohen BE, Edmondson D, Kronish IM. State of the art review: depression, stress, anxiety, and cardiovascular disease. Am J Hypertens. 2015;28(11):1295–302.PubMedPubMedCentral
32.
Moss D. Heart rate variability and biofeedback. Psychophysiology today. Mag Mind Body Med. 2004;1:4–11.
33.
Moravec CS. Biofeedback therapy in cardiovascular disease: rationale and research overview. Cleveland J Med. 2008;75:1.
34.
Carney RM, Freedland KE. Depression and heart rate variability in patients with coronary heart disease. Cleveland J Med. 2009;76(Supp 12):S13–7.
35.
McCraty R, Atkinson M, Tomasino D. The coherent heart: heart- brain interactions, psycho-physiologic coherence, and the emergence of syste-wide order. Integral Rev. 2009;5(2):10–115.
36.
McCraty R, Childre D. The grateful heart: the psychophysiology of appreciation. In: Emmons RA, McCullough ME, editors. The psychology of gratitude. New York: Oxford University Press; 2004. p. 230–55.
37.
Tiller WA, McCraty R, Atkinson M. Cardiac coherence: a new, noninvasive measure of autonomic nervous system order. Altern Ther Health Med. 1996;2(1):52–65.PubMed
38.
Lehrer P. Biofeedback training to increase heart rate variability. In: Lehrer PM, Wolf folk RL, Sime WE, editors. Principles and practice of stress management. 3rd ed. New York: Guilford Press; 2007.
39.
Lehrer P. “How does heart rate variability biofeedback work?”; resonance, baroreflex and other mechanisms. Biofeedback. 2013;41(1):26–31.
40.
Nolan RP, Kamath MV, Floras JS, Stanley J, Pang C, Picton P, Young QR. Heart rate variability biofeedback as a behavioral neuro-cardiac intervention to enhance vagal heart rate control. Am Heart J. 2005;149(6):1137.PubMed
41.
Allen B, Friedman B. Positive emotion reduces dyspnea during slow paced breathing. Psychophysiology. 2012;49:690–6.PubMed
42.
Delpozo JM, Gevirtz RN, Scher B, Guarneria E. Biofeedback treatment increases heart rate variability in patients with known coronary artery disease. Am Heart J. 2004;147(3):G1–6.
43.
44.
45.
Besharat MA. A survey on the psychoanalytical characteristics of depression, anxiety and stress DASS-21 scale among general and clinical populations. Tehran University Research Report; 2006.
46.
Carson VB. Prayer, meditation, exercise and special diets: behaviors of the hardy person with HIV/AIDS. J Am Nurs AIDS Care. 1993;4:18–28.
47.
Worthington E L, Sandage SJ & Berry JW. Group interventions to promote forgiveness. In M. E. McCullough, K. I. Pargament & C. E. Thoresen (Eds.), Forgiveness: Theory, research, and practice, New York: Guilford, 228-253.
48.
Raphael M, Harold G. Koenig. Mental disorders, Religion and Spirituality, 1990 to 2010: a systematic evidence—based review, J Religion Heath, 2013; 52(2):65-77.
49.
Amy GWDM, Naomi T, Eugenio AD. Incorporating religion/spirituality into treatment for serious mental illness. Cogn Behav Pract. 2010;17(40):348–57.
50.
Basak C, Hana A, Meredith P, Thomas M. Does religious activity improve health outcomes? A critical review of the recent literature. Explore. 2005;1:3.
51.
Syed AH. The effect of Islam on mental health; the Muslim perspective. Handbook of religion and mental health, U.S. University of Missouri at Columbia; 1998.
52.
Sahraian A, Gholami A, Javadpour A, Omidvar B. Association between Religiosity and Happiness among a group of Muslim undergraduate students. J Relig Health. 2013;52(2):450–3.PubMed
53.
Jesse J, Naghikivan J, Philip AP, Laurent C, Ernst RS. The effects of spirituality and religion on outcomes in patients with chronic heart failure. J Relig Health. 2012;5(4):1124–36.
54.
Ethel G, Nicdao AmyL AI. Religion and the use of complementary and alternative medicine among cardiac patients. J Relig Health. 2014;53(3):564–877.
55.
Harold GK, Saad-Al-Shohaib E. Health and well-being in islamic societies: background, research and application. New York: Springer; 2014. p. 141–9.
56.
Ferando AL, Harold GK. Religion, spirituality and cardiovascular disease; Research, clinical implication and opportunities in Brazil. RevistaBrasilera cirurgia Cardiovasc. 2015;28(970):103–28.
57.
Byrd RC. Positive therapeutic effects of intercessory prayer in a coronary care unit population. South Med J. 1988;81(7):826–9.PubMed
58.
Harris WS, Gowda M, Kolb JW, Strychacz CP, Vacek JL, Jones PG, et al. A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted of the coronary care unit. Arch Intern Med. 1999;159(19):2273–8.PubMed
59.
Benson H, Dusek JA, Sherwood JB, Lam P, Bethea CF, Carpenter W, et al. Study of the Therapeutic Effects of Intercessory Prayer (STEP) in cardiac bypass patients: a multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer. Am Heart J. 2006;151(4):934–42.PubMed
60.
Gevirtz RN. Psycho-physiologic perspectives on stress related and anxiety disorders. In: Lehrer PM, Wolffolk RL, Sime WE, editors. Priniciple and practice of stress management. 3rd ed. New York: Guilford Press; 2007. p. 273–6.
61.
Porges SW. The polyvagal theory: phylogenetic substances of a social nervous system. Int J Physiol. 2001;42:123–46.
62.
Yasuma F. Respiratory sinus arrhythmia: why does the heartbeat synchronize with respiratory rhythm? Chest. 2004;125:683–90.PubMed
63.
Khazan IZ. Heart rate variability. The clinical handbook of biofeedback: a step by step guide for training and practice with mindfulness. London: Wiley; 2013. p. 97–117.
Metadata
Title
A pilot randomized controlled trial to assess the effect of Islamic spiritual intervention and of breathing technique with heart rate variability feedback on anxiety, depression and psycho-physiologic coherence in patients after coronary artery bypass surgery
Authors
Mohiadin Amjadian
Hadi Bahrami Ehsan
Kaivan Saboni
Siamak Vahedi
Reza Rostami
Daem Roshani
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Annals of General Psychiatry / Issue 1/2020
Electronic ISSN: 1744-859X
DOI
https://doi.org/10.1186/s12991-020-00296-1

Other articles of this Issue 1/2020

Annals of General Psychiatry 1/2020 Go to the issue

Review

The role of shared decision-making in improving adherence to pharmacological treatments in patients with schizophrenia: a clinical review

Case report

A case report of mania with abnormal cerebral blood flow and cognitive impairment 24 years after head trauma

Primary research

Gray matter volume alterations associated with suicidal ideation and suicide attempts in patients with mood disorders

Primary research

Interrelation between defensive mechanisms and coping strategies in psychiatry trainees in Romania: a multicenter study

Primary research

Oncology nurses’ compassion fatigue, burn out and compassion satisfaction

Review

Neurocognitive impairment and evidence-based treatment options in Bipolar disorder