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Randomized Controlled Trial
. 2005 Dec;20(12):1084-90.
doi: 10.1111/j.1525-1497.2005.00256.x.

Improving Psychologic Adjustment to Chronic Illness in Cardiac Patients. The Role of Depression and Anxiety

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Free PMC article
Randomized Controlled Trial

Improving Psychologic Adjustment to Chronic Illness in Cardiac Patients. The Role of Depression and Anxiety

Thomas J McLaughlin et al. J Gen Intern Med. .
Free PMC article

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.

Figures

FIGURE 1
FIGURE 1
Study design flow chart.
FIGURE 2
FIGURE 2
Treatment effects on depression.
FIGURE 3
FIGURE 3
Treatment effects on anxiety.
FIGURE 4
FIGURE 4
Treatment effects on limitations in home activities.
FIGURE 5
FIGURE 5
Treatment effects on limitations in workplace activities.

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