Universität zu Köln

Deter, Hans-Christian, Weber, Cora, Herrmann-Lingen, Christoph, Albus, Christian, Juenger, Jana, Ladwig, Karl-Heinz, Soellner, Wolfgang, de Zwaan, Martina, Hellmich, Martin, Gruen, Anna-Sophia, Ronel, Joram and Orth-Gomer, Kristina (2018). Gender differences in psychosocial outcomes of psychotherapy trial in patients with depression and coronary artery disease. J. Psychosomat. Res., 113. S. 89 - 100. OXFORD: PERGAMON-ELSEVIER SCIENCE LTD. ISSN 1879-1360

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Abstract

Introduction: The biological and psychosocial risk profile differs between women and men with coronary artery disease (CAD). Depressive symptoms and Vital Exhaustion (VE) predict an unfavourable course of CAD. The secondary analysis of the SPIRR-CAD trial offered the possibility to examine gender as exposure variable of the clinical and psychological situation at baseline and in a variety of psychosocial measures as outcomes. Methods: In this trial, 450 men (78.9%) and 120 women (21.1%) with CAD (age <= 75 y), with mild to moderate depression (scoring >= 8 on the HADS), were randomized to usual care with or without a stepwise psychotherapy intervention. Beside clinical measures exhaustion and other indicators of depressive symptoms were collected at baseline and 18-month follow up. Results: Men had more signs and symptoms of heart disease at baseline, whereas women had higher psychosocial burden (e.g. negative affect). Women were more likely to live alone, had lower educational levels and employment rates and higher levels of depression and exhaustion. The psychotherapy intervention differed as a function of gender: In women, VE decreased from 29.4 +/- 8.1 to 22.1 +/- 11.7 in the intervention group (IG) and from 29.2 +/- 8.2 to 25.1 +/- 11.3 in the control group (CG). In men VE decreased from 23.3+ -10.8 to 21.2 +/- 9.7 in the IG and from 23.6 +/- 10.7 to 19.3 +/- 11.3 in the CG (time x intervention x gender; F = 4.97; p = .026). Discussion: Women had a higher psychosocial burden than men. VE compared to other rating instruments of depressive symptoms suggested a stronger response to the intervention in women. VE may help to understand gender differences in psychotherapeutic treatment studies of CAD. ISRCTN:76240576; clinicaltrials.gov

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Deter, Hans-Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Cora UNSPECIFIED UNSPECIFIED UNSPECIFIED Herrmann-Lingen, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Albus, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Juenger, Jana UNSPECIFIED UNSPECIFIED UNSPECIFIED Ladwig, Karl-Heinz UNSPECIFIED UNSPECIFIED UNSPECIFIED Soellner, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED de Zwaan, Martina UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Gruen, Anna-Sophia UNSPECIFIED UNSPECIFIED UNSPECIFIED Ronel, Joram UNSPECIFIED UNSPECIFIED UNSPECIFIED Orth-Gomer, Kristina UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-172103
DOI:	10.1016/j.jpsychores.2018.08.005
Journal or Publication Title:	J. Psychosomat. Res.
Volume:	113
Page Range:	S. 89 - 100
Date:	2018
Publisher:	PERGAMON-ELSEVIER SCIENCE LTD
Place of Publication:	OXFORD
ISSN:	1879-1360
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CARDIOVASCULAR MORTALITY RISK; ISCHEMIA SYNDROME EVALUATION; RANDOMIZED-CONTROLLED-TRIAL; ACUTE MYOCARDIAL-INFARCTION; ADVERSE CARDIAC EVENTS; HEART-DISEASE; VITAL EXHAUSTION; PSYCHOLOGICAL DISTRESS; ENHANCING RECOVERY; CLINICAL EVENTS Multiple languages Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17210