Internet-based Cognitive Behavior Therapy for Symptoms of Depression and Anxiety among Patients with a Recent Myocardial Infarction: The U-CARE Heart Randomized Trial

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Norlund, FredrikaUppsala universitet,Klinisk psykologi i hälso- och sjukvård (author)

Internet-based Cognitive Behavior Therapy for Symptoms of Depression and Anxiety among Patients with a Recent Myocardial Infarction : The U-CARE Heart Randomized Trial

Article/chapterEnglish2018

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2018-03-08
JMIR Publications Inc.2018
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:uu-336209
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-336209URI
https://doi.org/10.2196/jmir.9710DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Background: Symptoms of depression and anxiety are common after a myocardial infarction (MI). Internet-based cognitivebehavioral therapy (iCBT) has shown good results in other patient groups.Objective: The aim of this study was to evaluate the effectiveness of an iCBT treatment to reduce self-reported symptoms ofdepression and anxiety among patients with a recent MI.Methods: In total, 3928 patients were screened for eligibility in 25 Swedish hospitals. Of these, 239 patients (33.5%, 80/239women, mean age 60 years) with a recent MI and symptoms of depression or anxiety were randomly allocated to a therapist-guided,14-week iCBT treatment (n=117), or treatment as usual (TAU; n=122). The iCBT treatment was designed for post-MI patients.The primary outcome was the total score of the Hospital Anxiety and Depression Scale (HADS) 14 weeks post baseline, assessedover the internet. Treatment effect was evaluated according to the intention-to-treat principle, with multiple imputations. For themain analysis, a pooled treatment effect was estimated, controlling for age, sex, and baseline HADS.Results: There was a reduction in HADS scores over time in the total study sample (mean delta=−5.1, P<.001) but no differencebetween the study groups at follow-up (beta=−0.47, 95% CI −1.95 to 1.00, P=.53). Treatment adherence was low. A total of46.2% (54/117) of the iCBT group did not complete the introductory module.Conclusions: iCBT treatment for an MI population did not result in lower levels of symptoms of depression or anxiety comparedwith TAU. Low treatment adherence might have influenced the result.Trial Registration: ClinicalTrials.gov NCT01504191; https://clinicaltrials.gov/ct2/show/NCT01504191 (Archived at Webciteat http://www.webcitation.org/6xWWSEQ22)

Subject headings and genre

SAMHÄLLSVETENSKAP Psykologi hsv//swe
SOCIAL SCIENCES Psychology hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Medical Science
Medicinsk vetenskap

Added entries (persons, corporate bodies, meetings, titles ...)

Wallin, EmmaUppsala universitet,Institutionen för psykologi(Swepub:uu)emmwa608 (author)
Olsson, Erik,1967-Uppsala universitet,Klinisk psykologi i hälso- och sjukvård(Swepub:uu)erols031 (author)
Wallert, JohnUppsala universitet,Klinisk psykologi i hälso- och sjukvård(Swepub:uu)johwa648 (author)
Burell, GunillaUppsala universitet,Allmänmedicin och preventivmedicin(Swepub:uu)gunibure (author)
von Essen, Louise,1957-Uppsala universitet,Klinisk psykologi i hälso- och sjukvård(Swepub:uu)louiesse (author)
Held, Claes,1956-Uppsala universitet,Klinisk psykologi i hälso- och sjukvård,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)clahe947 (author)
Uppsala universitetKlinisk psykologi i hälso- och sjukvård (creator_code:org_t)

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In:Journal of Medical Internet Research: JMIR Publications Inc.20:31438-8871

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SOCIAL SCIENCES: SOCIAL SCIENCES; and Psychology

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