Anxiety Following Myocardial Infarction: A Systematic Review of Psychological Interventions

Objective: Anxiety is highly prevalent following myocardial infarction (MI) and is linked with adverse effects on a person's recovery, quality of life, physical health, and life expectancy. The primary objective of this systematic review was to assess the effectiveness of psychological interventions for anxiety following MI. Method: CINAHL, Medline, PsycINFO, PsycARTICLES, Cochrane Library, EMBASE, and Web of Science were systematically searched for studies that provided information on anxiety pre and post psychological intervention following MI. Results: Eighteen studies were included (15 randomized controlled trials [RCTs] and three non-RCTs). Within these studies, psychological interventions comprised cognitive behavioral therapy, eye movement desensitization reprocessing, counseling, psychotherapy, psychological/psychosocial cardiac rehabilitation, illness perception interventions, relaxation training, mindfulness, stress management, and other psychological-based programmes. Ten studies reported a significant decrease in anxiety following a psychological intervention, when compared with usual care. Three studies noted mixed results, and five studies reported no significant difference in anxiety following a psychological intervention. The interventions varied in length, setting, facilitation, and format. Poor reporting of information increased the risk of bias within studies. Conclusion: Psychological interventions may be beneficial to individuals who experience anxiety following a MI. No particular type of psychological intervention appears to be superior to others within the existing literature. Further rigorous research is needed to identify the needs of this population and the specific form of psychological intervention that is most effective in alleviating anxiety following MI. Clinical implications and recommendations for future research are provided.