Universität zu Köln

Herrmann-Lingen, Christoph, Beutel, Manfred E., Bosbach, Alexandra, Deter, Hans-Christian ORCID: 0000-0001-8575-4570, Fritzsche, Kurt, Hellmich, Martin, Jordan, Jochen, Juenger, Jana, Ladwig, Karl-Heinz, Michal, Matthias, Petrowski, Katja, Pieske, Burkert, Ronel, Joram, Soellner, Wolfgang, Stoehr, Andreas, Weber, Cora, de Zwaan, Martina and Albus, Christian (2016). A Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease (SPIRR-CAD): Results of an Observer-Blinded, Multicenter, Randomized Trial in Depressed Patients With Coronary Artery Disease. Psychosom. Med., 78 (6). S. 704 - 716. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1534-7796

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Abstract

Background: Depression predicts adverse prognosis in patients with coronary artery disease (CAD), but previous treatment trials yielded mixed results. We tested the hypothesis that stepwise psychotherapy improves depressive symptoms more than simple information. Methods: In a multicenter trial, we randomized 570 CAD patients scoring higher than 7 on the Hospital Anxiety and Depression Scale-depression subscale to usual care plus either one information session (UC-IS) or stepwise psychotherapy (UC-PT). UC-PT patients received three individual psychotherapy sessions. Those still depressed were offered group psychotherapy (25 sessions). The primary outcome was changed in the Hospital Anxiety and Depression Scale-depression scores from baseline to 18 months. Preplanned subgroup analyses examined whether treatment responses differed by patients' sex and personality factors (Type D). Results: The mean (standard deviation) depression scores declined from 10.4 (2.5) to 8.7 (4.1) at 18 months in UC-PT and from 10.4 (2.5) to 8.9 (3.9) in UC-IS (both p <.001). There was no significant group difference in change of depressive symptoms (group-by-time effect, p=.90). Preplanned subgroup analyses revealed no differences in treatment effects between men versus women (p(treatment-by-sex interaction)=.799) but a significant treatment-by-Type D interaction on change in depressive symptoms (p=.026) with a trend for stronger improvement with UC-PT than UC-IS in Type D patients (n= 341, p=.057) and no such difference in improvement in patients without Type D (n= 227, p=.54). Conclusions: Stepwise psychotherapy failed to improve depressive symptoms in CAD patients more than UC-IS. The intervention might be beneficial for depressed CAD patients with Type D personality. However, this finding requires further study.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Herrmann-Lingen, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Beutel, Manfred E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bosbach, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Deter, Hans-Christian UNSPECIFIED orcid.org/0000-0001-8575-4570 UNSPECIFIED Fritzsche, Kurt UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Jordan, Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED Juenger, Jana UNSPECIFIED UNSPECIFIED UNSPECIFIED Ladwig, Karl-Heinz UNSPECIFIED UNSPECIFIED UNSPECIFIED Michal, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Petrowski, Katja UNSPECIFIED UNSPECIFIED UNSPECIFIED Pieske, Burkert UNSPECIFIED UNSPECIFIED UNSPECIFIED Ronel, Joram UNSPECIFIED UNSPECIFIED UNSPECIFIED Soellner, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoehr, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Cora UNSPECIFIED UNSPECIFIED UNSPECIFIED de Zwaan, Martina UNSPECIFIED UNSPECIFIED UNSPECIFIED Albus, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-270747
DOI:	10.1097/PSY.0000000000000332
Journal or Publication Title:	Psychosom. Med.
Volume:	78
Number:	6
Page Range:	S. 704 - 716
Date:	2016
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1534-7796
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COGNITIVE-BEHAVIORAL THERAPY; HEART-DISEASE; CARDIOVASCULAR EVENTS; MYOCARDIAL-INFARCTION; COLLABORATIVE CARE; PROGNOSTIC ASSOCIATION; ENHANCING RECOVERY; D PERSONALITY; MORTALITY; ANXIETY Multiple languages Psychiatry; Psychology; Psychology, Multidisciplinary Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27074