A Randomized Controlled Trial of Cognitive Behavior Therapy Tailored to Psychological Adaptation to an Implantable Cardioverter Defibrillator
| Autor: | Joel Katz, Louise Harris, Robert A. Cribbie, Paul Dorian, Jane Irvine, Samuel F. Sears, Suzan O'Donnell, Jill Firestone, Sabine N. Johnson, Lephuong Ong, Doug Cameron, David Newman, Ann Hill, Paul Ritvo, Ana Bilanovic |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment law.invention Stress Disorders Post-Traumatic Quality of life Randomized controlled trial law Intervention (counseling) Psychological adaptation Adaptation Psychological Humans Medicine Applied Psychology Aged Cognitive Behavioral Therapy business.industry Arrhythmias Cardiac Cognition Middle Aged Implantable cardioverter-defibrillator Defibrillators Implantable Psychiatry and Mental health Death Sudden Cardiac Treatment Outcome Cardiac psychology Quality of Life Physical therapy Female Implant business |
| Zdroj: | Psychosomatic Medicine. 73:226-233 |
| ISSN: | 0033-3174 |
| DOI: | 10.1097/psy.0b013e31820afc63 |
| Popis: | To evaluate a eight-session cognitive behavior therapy (CBT) intervention tailored to adaptation in implantable cardioverter defibrillator (ICD) patients; and to test for treatment group by gender interaction effects.Patients receiving their first ICD implant were randomized to CBT or usual cardiac care. Primary outcomes measured at baseline, 6-month, and 12-month follow-ups were symptoms of anxiety and depression (Hospital Anxiety and Depression Scale), posttraumatic stress disorder symptoms (Impact of Events Scale-Revised), and phobic anxiety (Crown-Crisp Experiential Index). Secondary outcomes were quality of life (Short Form-36 Physical Component Summary and Short Form-36 Mental Component Summary) and ICD shocks or antitachycardia pacing therapies.Of 292 eligible patients, 193 consented and were randomized to CBT (n = 96) or usual cardiac care (n = 97). Eighty percent were male; mean age was 64.4 years (standard deviation = 14.3); and 70% received an ICD for secondary prevention. No baseline differences were observed between the treatment conditions; however, women scored worse than men on all psychological and quality of life variables (p.05). Eighty-three percent completed follow-up. Repeated-measures analyses of covariance revealed significantly greater improvement with CBT on posttraumatic stress disorder total and avoidance symptoms for men and women combined (p.05) and significantly greater improvement in depressive symptoms and Short Form-36 Mental Component Summary only in women (p.01). No differences were observed between treatment conditions on ICD therapies over follow-up.A CBT intervention to assist adaptation to an ICD enhanced psychological functioning over the first year post implant. |
| Databáze: | OpenAIRE |
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