Effectiveness of Cognitive Behavioral Therapy on Psychological Distress among Myocardial Infarction Survivors: A Systematic Review

Cognitive behavioral therapy (CBT) is effective in reducing depression, anxiety, and stress among individuals with cardiovascular disease; however, empirical evidence in myocardial infarction (MI) survivors remains limited. Furthermore, the design features of CBT that alleviate psychological distress require further investigation. This systematic review aimed to evaluate the effectiveness of CBT in reducing psychological distress among myocardial infarction (MI) survivors and to identify the design features that support emotional recovery. A systematic review was conducted using six databases with 13 randomized controlled trials (RCTs) published between 2014 and 2023 that met the inclusion criteria. Methodological quality was assessed using the Joanna Briggs Institute, and the data were synthesized narrative style. Metanalysis was not feasible. Thirteen RCTs involving 1,586 participants were included. CBT or CBT-based approaches—delivered face-to-face or through technology-assisted formats—were shown to significantly reduce depression, anxiety, and stress compared with standard care, and both combined and internet-based CBT programs showed comparable effectiveness. Additionally, several studies reported improved sleep quality and cardiac biomarkers. CBT is effective in the alleviation of psychological distress among MI survivors. Thus, integrating face-to-face or technology-assisted CBT into psychosocial nursing practice can enhance their emotional well-being and recovery outcomes.