Effectiveness of cognitive behavioral therapy on mood symptoms in patients with implantable cardioverter defibrillator: A systematic review and meta-analysis

Background: and purpose: Cognitive behavioral therapy (CBT) has gained increasing attention in the treatment of psychological disorders, but evidence is required to support practice. This systematic review was conducted to evaluate the current evidence for CBT's effectiveness in relieving symptoms of anxiety and depression experienced by patients with an implantable cardioverter-defibrillator (ICD). Methods: PubMed, Cochrane Library, Web of Science, and Embase databases were systematically searched from inception to March 27, 2020. Both randomized controlled trials and cluster-randomized controlled trials were included in our review. Meta-analysis was conducted using RevMan 5.3 and Stata 15.1 software. Results: A total of six trials, including 675 participants, were analyzed. The results demonstrated that CBT was superior to standard care in relieving symptoms of depression (standardized mean difference = -0.20; 95% confidence interval (CI):-0.39 to-0.01; P = 0.004). The effectiveness of CBT in relieving symptoms of anxiety experienced by patients with ICDs (standardized mean difference = -0.70; 95% CI:-1.10 to-0.30; P < 0.001) as well as the heterogeneity (I-2 = 77%) were significant. Conclusion: This meta-analysis indicates that CBT effectively relieves symptoms of anxiety and depression experienced by patients with ICDs. Clinical personnel should pay close attention to the mental health of patients with ICDs and adopt CBT as a management strategy for such patients.