Improving psychologic adjustment to chronic illness in cardiac patients. The role of depression and anxiety
Department of Pediatrics; Department of Psychiatry
Adaptation, Psychological; Aged; Angina, Unstable; Anxiety; Chronic Disease; Counseling; Depression; Female; Humans; Male; Middle Aged; Myocardial Infarction; Myocardial Ischemia; Prospective Studies; Recovery of Function; Telephone
Life Sciences | Medicine and Health Sciences
BACKGROUND: Poor mood adjustment to chronic medical illness is often accompanied by decrements in function. OBJECTIVE: To evaluate the effectiveness of a telephone-based intervention for psychologic distress and functional impairment in cardiac illness. DESIGN: Randomized, controlled trial. METHODS: We recruited survivors of acute coronary syndromes using the Hospital and Anxiety Depression Scale (HADS) with scores indicative of mood disturbances at 1-month postdischarge. Recruited patients were randomized to experimental or control status. Intervention patients received 6 30-minute telephone counseling sessions to identify and address illness-related fears and concerns. Control patients received usual care. Patients' responses to the HADS and the Workplace Social Adjustment Scale (WSAS) were collected at baseline, 2, 3, and 6 months using interactive voice recognition technology. At baseline, the PRIME-MD was used to establish diagnosis of depression. We used mixed effects regression to study changes in outcomes. RESULTS: We enrolled 100 patients. Mean age was 60; 67% of the patients were male. Findings confirmed that the intervention group had a 27% improvement in depression symptoms (P=.05), 27% in anxiety (P=.02), and a 38% improvement in home limitations (P=.04) compared with controls. Symptom improvement tracked those for WSAS measures of home function (P=.04) but not workplace function. CONCLUSIONS: The intervention had a moderate effect on patient's emotional and functional outcomes that were observed during a critical period in patients' lives. Patient convenience, ease of delivery, and the effectiveness of the intervention suggest that the counseling can help patients adjust to chronic illness.
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Citation: J Gen Intern Med. 2005 Dec;20(12):1084-90. Link to article on publisher's site
DOI of Published Version
Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine
McLaughlin, Thomas J.; Aupont, Onesky; Bambauer, Kara Z.; Stone, Peter H.; Mullan, Mariquita G.; Colagiovanni, Jane; Polishuk, Elaine; Johnstone, Michael T.; and Locke, Steven E., "Improving psychologic adjustment to chronic illness in cardiac patients. The role of depression and anxiety" (2006). Open Access Articles. 1057.