Title

Improving psychologic adjustment to chronic illness in cardiac patients. The role of depression and anxiety

UMMS Affiliation

Department of Pediatrics; Department of Psychiatry

Date

1-21-2006

Document Type

Article

Subjects

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

Disciplines

Life Sciences | Medicine and Health Sciences

Abstract

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.

Rights and Permissions

Citation: J Gen Intern Med. 2005 Dec;20(12):1084-90. Link to article on publisher's site

DOI of Published Version

10.1111/j.1525-1497.2005.00256.x

Related Resources

Link to Article in PubMed

Journal Title

Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine

PubMed ID

16423095