| Early Cognitive Behavioral Therapy for Depression After Cardiac Surgery. | |
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MedLine Citation:
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PMID: 22635060 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: Despite high rates of postcardiac surgery depression, studies of depression treatment in this population have been limited. OBJECTIVE:: The aim of this study was to evaluate early cognitive behavioral therapy (CBT) in a home environment in patients recovering from cardiac surgery. METHODS:: From July 2006 through October 2009, we conducted a randomized controlled trial and enrolled 808 patients who were screened for depressive symptoms using the Beck Depression Inventory (BDI) in the hospital and 1 month later. Patients were interviewed using the Structured Clinical Interview for DSM-IV; those who met criteria for clinical depression (n = 81) were randomized to CBT (n = 45) or usual care (UC; n = 36). After completion of the UC period, 25 individuals were offered later CBT (UC + CBT). RESULTS:: Main outcomes (depressive symptoms [BDI] and clinical depression [Structured Clinical Interview for DSM-IV]) were evaluated after 8 weeks using intention-to-treat principles and linear mixed models. Compared with the UC group, in the CBT group, there was greater decline in BDI scores (β = 1.41; 95% confidence interval [CI], 0.81-2.02; P = < .001) and greater remission of clinical depression (29 [64%] vs 9 [25%]; number need to treat, 2.5; 95% CI, 1.7-4.9; P < .001). Compared with the early CBT group (median time from surgery to CBT, 45.5 days) the later UC + CBT group (median time from surgery to CBT, 122 days) also experienced a reduction in BDI scores, but the group × time effect was smaller (β = 0.79; 95% CI, 0.10-1.47; P = .03) and remission rates between the 2 groups did not differ. CONCLUSIONS:: Early home CBT is effective in depressed postcardiac surgery patients. Early treatment is associated with greater symptom reduction than similar therapy given later after surgery. |
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Authors:
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Lynn V Doering; Belinda Chen; Rebecca Cross Bodán; Marise C Magsarili; Adey Nyamathi; Michael R Irwin |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-5-24 |
Journal Detail:
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Title: The Journal of cardiovascular nursing Volume: - ISSN: 1550-5049 ISO Abbreviation: - Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-5-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8703516 Medline TA: J Cardiovasc Nurs Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Lynn V. Doering, RN, DNSc, FAAN Professor and Chair, Acute Care, School of Nursing, University of California, Los Angeles. Belinda Chen, MPH Project Director, School of Nursing, University of California, Los Angeles. Rebecca Cross Bodán, PhD, NP Assistant Professor, School of Nursing, California State University, Fullerton. Marise C. Magsarili, MN, RN Nurse Practitioner, Kaiser Permanente Medical Center, Los Angeles, California. Adey Nyamathi, PhD, ANP, FAAN School of Nursing, University of California, Los Angeles. Michael R. Irwin, MD Professor and Director, Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Semel Institute for Neuroscience, and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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