Months of follow-up with the chronic disease. Intervention can be given in the form of a regular education session, on an individual basis or in a group. The effectiveness of this type of intervention is not clearly established. Ries et al. found no significant changes in depression after outpatient rehabilitation, although the self-assessed efficacy for walking distance improved [43]. In contrast, Dekhuijzen et al. showed a beneficial effect on anxiety and depression [69]. These studies, however, used different outcome measures, so that it is difficult to draw conclusions. At present, although it is assumed that psychological interventions are needed in some patients, there is no convincing evidence in the literature that this is beneficial.

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