Universität zu Köln

Albus, Christian, Beutel, Manfred E., Deter, Hans-Christian ORCID: 0000-0001-8575-4570, Fritzsche, Kurt, Hellmich, Martin ORCID: 0000-0001-5174-928X, Jordan, Jochen, Juenger, Jana, Krauth, Christian, Ladwig, Karl-Heinz ORCID: 0000-0003-0710-1720, Michal, Matthias, Mueck-Weymann, Michael, Petrowski, Katja, Pieske, Burkert, Ronel, Joram, Soellner, Wolfgang, Waller, Christiane, Weber, Cora and Herrmann-Lingen, Christoph (2011). A Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease (SPIRR-CAD) - Rationale and design of a multicenter, randomized trial in depressed patients with CAD. J. Psychosomat. Res., 71 (4). S. 215 - 223. OXFORD: PERGAMON-ELSEVIER SCIENCE LTD. ISSN 1879-1360

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Abstract

Objective: Depressive symptoms are highly relevant for the quality of life, health behavior, and prognosis in patients with coronary artery disease (CAD). However, previous psychotherapy trials in depressed CAD patients produced small to moderate effects on depression, and null effects on cardiac events. In this multicentre psychotherapy trial, symptoms of depression are treated together with the Type D pattern (negative affectivity and social inhibition) in a stepwise approach. Methods: Men and women (N=569, age 18-75 years) with any manifestation of CAD and depression scores >= 8 on the Hospital Anxiety and Depression Scale (HADS), will be randomized (allocation ratio 1:1) into the intervention or control group. Patients with severe heart failure, acutely life-threatening conditions, chronic inflammatory disease, severe depressive episodes or other severe mental illness are excluded. Both groups receive usual medical care. Patients in the intervention group receive three initial sessions of supportive individual psychotherapy. After re-evaluation of depression (weeks 4-8), patients with persisting symptoms receive an additional 25 sessions of combined psychodynamic and cognitive-behavioral group therapy. The control group receives one psychosocial counseling session. Primary efficacy variable is the change of depressive symptoms (HADS) from baseline to 18 months. Secondary endpoints include cardiac events, remission of depressive disorder (SCID) and Type D pattern, health-related quality of life, cardiovascular risk profile, neuroendocrine and immunological activation, heart rate variability, and health care utilization, up to 24 months of follow-up (ISRCTN: 76240576; NCT00705965). Funded by the German Research Foundation. (C) 2011 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Albus, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Beutel, Manfred E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Deter, Hans-Christian UNSPECIFIED orcid.org/0000-0001-8575-4570 UNSPECIFIED Fritzsche, Kurt UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED orcid.org/0000-0001-5174-928X UNSPECIFIED Jordan, Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED Juenger, Jana UNSPECIFIED UNSPECIFIED UNSPECIFIED Krauth, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Ladwig, Karl-Heinz UNSPECIFIED orcid.org/0000-0003-0710-1720 UNSPECIFIED Michal, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueck-Weymann, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Petrowski, Katja UNSPECIFIED UNSPECIFIED UNSPECIFIED Pieske, Burkert UNSPECIFIED UNSPECIFIED UNSPECIFIED Ronel, Joram UNSPECIFIED UNSPECIFIED UNSPECIFIED Soellner, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Waller, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Cora UNSPECIFIED UNSPECIFIED UNSPECIFIED Herrmann-Lingen, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-488138
DOI:	10.1016/j.jpsychores.2011.02.013
Journal or Publication Title:	J. Psychosomat. Res.
Volume:	71
Number:	4
Page Range:	S. 215 - 223
Date:	2011
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 HEART-DISEASE; MYOCARDIAL-INFARCTION; PSYCHOSOCIAL RISK; MAJOR DEPRESSION; MORTALITY; PERSONALITY; ASSOCIATION; EFFICACY; OUTCOMES; ANXIETY Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48813