Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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

Thomas J McLaughlin  1 , Onesky Aupont, Kara Z Bambauer, Peter Stone, Mariquita G Mullan, Jane Colagiovanni, Elaine Polishuk, Michael Johnstone, Steven E Locke
Affiliations
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. 2005 Dec.

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.

PubMed Disclaimer

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.
See this image and copyright information in PMC

References

    1. McGovern PG, Pankow JS, Shahar E, et al. Recent trends in acute coronary heart disease mortality, morbidity, medical care, and risk factors. N Engl J Med. 1996;334:884–90. - PubMed
    1. Lenexa RD, Scott-Lenexa JA, Bohlig EM. The cost of depression-complicated alcoholism health-care utilization and treatment effectiveness. J Ment Health Adm. 1993;20(Summer):138–52. - PubMed
    1. Reisner C, Gondek K, Musheno M, Menioge S, Mandel M. Depression severity and smoking history, but not age or fev1highly correlate with total charges and medical resource utilization in chronic obstructive pulmonary disease. ACCP Annual Meeting Chest. 1998;114(suppl 4):341S. (abstract).
    1. Friedman R, Sobel D, Meyers P, Caudillo M, Benson H. Behavioral medicine, clinical health psychology, and cost offset. Health Psychol. 1995;14:509–18. - PubMed
    1. Clark NM, Becker MH. Theoretical Models and Strategies for Improving Adherence and Disease Management. Handbook of Health Behavior Change. New York: Springer Verlag; 1998.

Publication types

MeSH terms