Effectiveness of problem-solving therapy for depression and dysfunctional attitudes in patients after coronary artery bypass graft surgery: a randomized clinical trial
Researcher Bulletin of Medical Sciences,
Vol. 26 No. 1 (2021),
30 October 2021
Objective: In patients with coronary artery bypass depression is common and a major cause of mortality after graft surgery. The purpose of this study was to determine the effectiveness of problem solving therapy (PST) in patients with coronary artery bypass by assessing changes in depression and dysfunctional attitudes after graft surgery.
Material and Methods: This randomized controlled trial conducted in Tehran Shahid Modarres Hospital in autumn 2018. Intervention group received PST individually in six sessions of one-hour per week and control group only received education of usual care program for two sessions. At the end of the intervention course and Follow up, both groups were tested simultaneously using the Research tools and the data were analyzed by repeated measures analysis of variance using SPSS-18 software.
Results: Patients receiving PST intervention showed significant improvement based BDI (P=0.018) and DSA-26 (P= 0.009). Also, compared with Usual Care, BDI remission of rates were superior in the PST group (P= 0.001) and larger decrease on the dysfunctional attitudes in the DAS-26 at two follow up times (P= 0.001).
Conclusions: These results shows that PST will be effective in reducing depression and dysfunctional attitudes in among patients with Coronary Artery Bypass Graft surgery. Then PST is an effective intervention that can improve problem-solving abilities and mental health-related in CABG surgery patients
- Coronary artery bypass graft surgery; Dysfunctional attitudes; Depression; Problem solving therapy
How to Cite
2. Huffman JC, Celano CM, Beach SR, Motiwala SR, Januzzi JL. Depression and cardiac disease: epidemiology, mechanisms, and diagnosis. Cardiovasc psychiatry Neurol 2013;2013:1-14.
3. Baune BT, Stuart M, Gilmour A, Wersching H, Heindel W, Arolt V, Berger K. The relationship between subtypes of depression and cardiovascular disease: a systematic review of biological models. Transl psychiatry 2012;2:1-19.
4. Messerli-Bürgy N, Barth J, Berger T. The InterHerz project-a web-based psychological treatment for cardiac patients with depression: study protocol of a randomized controlled trial. Trials 2012;13:245-251.
5. Stenman M, Holzmann MJ, Sartipy U. Relation of major depression to survival after coronary artery bypass grafting. Am J Cardiol 2014;114:698-703.
6. Mallik S, Krumholz HM, Lin ZQ, Kasl SV, Mattera JA, Roumains SA, Vaccarino V. Patients with depressive symptoms have lower health status benefits after coronary artery bypass surgery. Circulation 2005;111:271-277.
7. Simha Ravven M, Bader C, Azar A, Rudolph JL. Depressive symptoms after CABG surgery: a meta-analysis. Harv Rev psychiatry 2013;21:59-69.
8. Beresnevaitė M, Benetis R, Taylor GJ, Jurėnienė K, Kinduris Š, Barauskienė V. Depression predicts perioperative outcomes following coronary artery bypass graft surgery. Scand Cardiovasc J 2010;44:289-294.
9. Tully PJ. Psychological depression and cardiac surgery: a comprehensive review. J Extra Corpor Technol 2012;44:224-232.
10. Fuhr K, Reitenbach I, Kraemer J, Hautzinger M, Meyer TD. Attachment, dysfunctional attitudes, self-esteem, and association to depressive symptoms in patients with mood disorders. J Affect Disord 2017;212:110-116.
11. Meyer JH, McMain S, Kennedy SH, Korman L, Brown GM, DaSilva JN, Wilson AA, Blak T, Eynan-Harvey R, Goulding VS, Houle S. Dysfunctional attitudes and 5-HT2 receptors during depression and self-harm. Am J Psychiatry 2003;160:90-99.
12. Safaie N, Jodati AR, Raoofi M, Khalili M. Depression in Coronary Artery Disease. J Cardiovasc Thorac Res 2012;4:77-79.
13. Depression C. Effects of Treating Depression and Low Perceived Social Support on Clinical Events After Myocardial Infarction. JAMA 2003;289:3106-3116.
14. Doering LV, Cross R, Vredevoe D, Martinez-Maza O, Cowan MJ. Infection, depression, and immunity in women after coronary artery bypass: a pilot study of cognitive behavioral therapy. Altern Ther Health Med 2007;13:18-21.
15. Freedland KE, Skala JA, Carney RM, Rubin EH, Lustman PJ, Dávila-Román VG, Steinmeyer BC, Hogue CW. Treatment of depression after coronary artery bypass surgery: a randomized controlled trial. Arch Gen psychiatry 2009;66:387-396.
16. Gulliksson M, Burell G, Vessby B, Lundin L, Toss H, Svärdsudd K. Randomized controlled trial of cognitive behavioral therapy vs standard treatment to prevent recurrent cardiovascular events in patients with coronary heart disease: Secondary Prevention in Uppsala Primary Health Care project (SUPRIM). Arch Intern Med 2011;171:134-140.
17. Norlund F, Olsson EM, Burell G, Wallin E, Held C. Treatment of depression and anxiety with internet-based cognitive behavior therapy in patients with a recent myocardial infarction (U-CARE Heart): study protocol for a randomized controlled trial. Trials 2015;16:154-161.
18. Thomas P, Michael GK, Gary NE, Pharm D, Eugene JB. Assessment and treatment of depression following myocardial infarction. Am Fam Physician 2001;64:641-648.
19. D'Zurilla TJ, Nezu AM. Problem-solving therapy: A positive approach to clinical intervention. 3rd Ed. New York: Springer; 2007. p. 1-10.
20. Eskin M. Components of Problem solving Therapy. In: Eskin M. Problem solving therapy in the clinical practice. 1st Ed. London/Waltham: Elsevier; 2012. p. 17-26.
21. Gellis ZD, Bruce ML. Problem-solving therapy for subthreshold depression in home healthcare patients with cardiovascular disease. Am J Geriat Psychiatry 2010;18:464-474.
22. Lilly CL, Bryant LL, Vu MB, Hill-Briggs F, Samuel-Hodge CD, McMilin CR, Keyserling TC. Evaluation of the effectiveness of a problem-solving intervention addressing barriers to cardiovascular disease prevention behaviors in 3 underserved populations: Colorado, North Carolina, West Virginia, 2009. Prev Chronic Dis 2014;11: 1-10.
23. Beck AT, Steer RA, Ball R, Ranieri WF. Comparison of Beck Depression Inventories-IA and-II in psychiatric outpatients. J Pers Assess 1996;67:588-597.
24. Dobson K, Mohammd Khani P. PSYCHOMETRIC CHARACTERISTICS OF BECK DEPRESSION INVENTORY – II IN PATIENTS WITH MAJOR DEPRESSIVE DISORDER. Archives of Rehabilitation. 2015; 8: 82-88.
25. Ebrahimi A, Samouei R, Mousavii SG, Bornamanes AR. Development and validation of 26‐item dysfunctional attitude scale. Asia Pac Psychiatry 2013;5:101-7.
26. Ebrahimi A, Afshar H, Doost HTN, Mousavi SG, Moolavi H. Attitude scale and general health questionnaire subscales predict depression? J Res Med Sci 2012;17:40-44.
27. McMurran M, Day F, Reilly J, Delport J, McCrone P, Whitham D, Tan W, Duggan C, Montgomery AA, Williams HC, Adams CE. Psychoeducation and Problem Solving (PEPS) therapy for adults with personality disorder: a pragmatic randomized-controlled trial. J Pers Disord 2017;31:810-26.
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