Conclusions We found that psychological intervention  improved psychological symptoms and reduced cardiac mortality for people with CHD .
However , there remains considerable uncertainty regarding the magnitude of these effects and the specific techniques most likely to benefit people with different presentations of CHD
Background Although psychological interventions are recommended for the management of coronary heart disease ( CHD ) , there remains considerable uncertainty regarding their effectiveness .
A randomized control trial of cardiac rehabilitation.
A r and omized trial using controls tested whether psycho-social rehabilitation of acute myocardial infa rct ion ( MI ) patients would improve significantly their return to work rate and assessed the importance of various psychological , social , occupational , socio-demographic , and medical factors in facilitating or impeding rapid return to work .  Eighty-nine patients were assigned r and omly to participate in an experimental cardiac rehabilitation program ( rehab care ) , and 91 patients were controls who received conventional hospital rehabilitation ( usual care ) .  By the first follow-up interview at three months , patients assigned to experimental treatment were significantly less distressed psychologically and less dependent on family support than controls ( P = 0.04 and P = 0.05 , respectively ) . By the final follow-up interview at 13 months , there was a marginally significant difference in favor of the experimental group in the frequency of reported deterrents to work resumption ( P = 0.07 ) . However , the intervention did not result in a statistically significant difference in the return to work rate ( P greater than 0.10 ) . In each group , 88 % were back at work by approximately the first year after infa rct ion . In addition , the two groups were similar in the amount of time patients remained out of the workforce ( median days rehab care = 75 , usual care = 81 ; P greater than 0.10 ) . A multi-stage data analysis procedure utilizing the Cox regression technique indicated that while several independent variables had significant univariate associations with the length of time patients convalesced , outcome was most influenced by the patient 's initial cardiological status and clinical course , by the patterns of family support , and by the several variables measuring the presence of obstacles to resuming work . Our findings suggest that rehabilitation programs intervening on multiple levels ( psychological , social , occupational , and physical ) may best meet the needs of chronically ill cardiac patients . Results indicate that implementing measures addressing the patient 's general psycho-social adjustment to MI may improve existing programs
Conclusions We found that psychological intervention  improved psychological symptoms and reduced cardiac mortality for people with CHD .
However , there remains considerable uncertainty regarding the magnitude of these effects and the specific techniques most likely to benefit people with different presentations of CHD
Background Although psychological interventions are recommended for the management of coronary heart disease ( CHD ) , there remains considerable uncertainty regarding their effectiveness .