The modification of quality of life, well-being, psychosomatic and psychopatological distress in cardiac rehabilitation.

Introduction: Several studies documented the positive effects of cardiac rehabilitation (CR) on psychological distress. However, most of the research is focused on depression and anxiety, neglecting aspects with relevant clinical implications, such as psychosomatic diseases and well-being. The aim of this research was to evaluate the impact of CR on psychiatric and psychosomatic pathology, quality of life, psychological well-being and sub-clinical distress. Methods: The experimental group (N=108), undergoing CR, was compared to a control group (N=85) of patients affected by cardiovascular diseases, not undergoing CR. The assessment included: the Structured Clinical Interview for DSM-IV (depression and anxiety), the structured interview based on Diagnostic Criteria for Psychosomatic Research (DCPR), MOS 36-Item Short Form Health Survey (SF-36), Symptom Questionnaire (SQ) and Psychological Well-Being Scales (PWB). Results: 40.4% of the sample showed a DSM diagnosis, 62.1% suffered from at least one DCPR syndrome. Compared to the control group, CR was associated to the reduction of the most frequently observed psychiatric and psychosomatic diagnoses at baseline and to the enhancement of quality of life. On the contrary, there were no relevant effects on sub-clinical distress and well-being, except for purpose in life (PWB). Discussion/conclusion: The findings suggest that psychopathology and psychosomatic suffering observed at baseline could be reactive to the cardiac event. However, persisting residual subclinical distress and impairments in well-being should be evaluated in a comprehensive psychosomatic assessment, since they could be linked with the exacerbation of psychiatric or cardiac diseases.