Document Type : Research Article

Abstract

Depression as a usual disorder in coronary heart disease decreases mental health and ejection fraction of these patients. The purpose of this study was to investigate the effectiveness of individual and group cognitive-behavioral therapies on depression decrease and ejection fraction increase in coronary heart disease, and to compare the two psychotherapy methods. Subjects were coronary heart disease patients between ages of 30 to 60 with medium or severe depression. The subjects were randomly assigned to three matched groups, including two experimental groups for individual cognitive-behavioral therapy (n=20) and group cognitive-behavior therapy (n=16) and a control group (n=20). The control group received no psychological treatment. The patients were selected using available sampling method. All participants completed the Beck Depression Inventory-II, as well as, Ejection Fraction Test as pre-tests and post-tests. Data was analyzed using repeated measures and Scheffé test. Individual and group cognitive-behavioral therapies had significant effects on depression reduction, but they had no effect on ejection fraction increase in coronary heart disease patients. Regarding to depression reduction, there was no significant difference between the two methods. Individual and group cognitive-behavioral therapies can reduce the rate of depression and lessen the need to psychiatric drugs in coronary heart disease patients.

Keywords

بحرینیان، عبدالحمید و داوودی، محبوبه (۱۳۸۷). مقایسه تأثیر روش‌های درمان رفتاری و شناختی- رفتاری. پژوهش در پزشکی، ۳۲ (۴): ۲۸۹-۲۹۶.
بیاضی، محمدحسین، احدی، حسن، فتی، لادن، دانش ثانی، هاشم (۱۳۹۱). اثربخشی مداخله شناختی رفتاری گروهی کوتاه مدت بر افسردگی، اضطراب و تنش بیماران کرونری قلب مزمن: یک آزمایه کنترل شده‌ی تصادفی. مجله اصول بهداشت روانی, ۱۴ (۱): ۱۱-۲۱.
بیگدلی، ایمان الله و رحیمیان بوگر، اسحاق (۱۳۹۲). اثربخشی درمان فعّال سازی رفتاری و قراردادی گروهی بر افسردگی، اضطراب و استرس زناشویی در بیماران کرونر قلبی. فصلنامه روان‌شناسی بالینی، ۲ (۴):۱۹-۲۷.
توسلی، علی اکبر و خرم، زیبا (۱۳۷۹). عملکرد بطن چپ بیماران با انفارکتوس قلبی به همراه عارضه تاکی آریتمی فوق بطنی. مجله دانشکده پزشکی اصفهان، ۱۸(۵۹): ۱۹-۲۶.
رحیمی، چنگیز (۱۳۹۳). کاربرد پرسشنامه افسردگی بک – ۲ در دانشجویان ایرانی. روان‌شناسی بالینی و شخصیت، ۱۰: ۱۷۳-۱۸۸.
محمد خانی، پروانه و دابسون، کیت استفان (۱۳۸۶). مختصات روانسنجی پرسشنامه افسردگی بک-۲ در یک نمونه بزرگسالان مبتلا به افسردگی اساسی، ویژه‌نامه توانبخشی در بیماری‌ها و اختلالات روانی، ۲۹: ۸۰-۸۶.
هاوتون، کرک و سالکوویس کیس، کلارک (۱۳۸۲). رفتار درمانی شناختی. ترجمه حبیب اله قاسم‌زاده. تهران، انتشارات ارجمند.
American Heart Association. (2006). International Cardiovascular Disease Statistics. Dallas: American Heart Association.
Anisman, H., & Merali, Z. (2002). Cytokines stress and depressive illness. Behavior and Immunity, 16, 513-524.
Ariyo, A. A., Haan, M., Tangen, C. M., & et al. (2000). The Cardiovascular Heart Study Collaborative Research Group: Depressive symptoms and risks of coronary heart disease and mortality in elderly Americans. Circulation, 102, 1773-1779.
Barth, J., Schumacher, M., & Herrmann-Lingen, C. (2004). Depression as a risk factor for mortality in patients with coronary heart disease: A meta-analysis. Psychosomatic Medicine, 66, 802–813.
Baumeister, H., Hutter, N., & Bengel, J. (2011). Psychological and pharmacological interventions for depression in patients with coronary artery disease. Cochrane Database of Systematic Reviews, 7(9), CD008012. doi: 10.1002/14651858.CD008012.pub3.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory–II. San Antonio, TX: Psychological Corporation.
Berkman, L. F., Blomenthal J., Burg, M., Carney, R. M., Cathellier, D., Cowan, M. J., & et al. (2003). Effects of Treating Depression and Low Perceived Social Support on Events after Myocardial Infarction: The Enhancing Recovery in Coronary Heart Disease Patient (ENRICH) Randomized Trial. JAMA, 289(23), 3106-3116.
Blomental, J. A., & Sherwood, A. (2005). Effect of exercise and stress management training on markers of cardiovascular risk in patients with ischemic heart disease. A randomised controlled trial. JAMA, 293 (13), 1626-1634.
Bonow, R. O., Samaha L. A., Smith J. S. C., Mensah, G. A., & Lenfant, C. (2002). The international burden of cardiovascular disease: Responding to the emerging global epidemic. Circulation, 106, 1602–1605.
Bunker, S. T., Tonkin, A. M., Colquon, D. M., Esler, M. D., Hickie, I. B., Hunt, D., Jelinek, M. V., Oldenburg, B. F., Peach, H. G., Ruth, D., & Tennant, C. C. (2003). Stress and coronary heart disease: Psychological risk factors. National Heart Association of Australia Position Statement Update. Medical Journal of Australia, 178(6), 272-276.
Burell, G. (1996). Group psychotherapy in Project New Life: Treatment of coronary prone behaviors for patients who had coronary artery bypass graft surgery. In R. Allen and S. Scheidt (Eds), Heart and mind: The practice of cardiac psychology (291-310). Washington, DC: American Psychological Association.
Burg, M. M., Benetto, M. C., & Soufer, R. L. (2003). Presurgical depression predicts medical morbidity 6 months after coronary artery bypass graft surgery. Psychosomatic Medicine, 65(1), 111–8.
Carney, R. M, Freedland, K. E., Miller, G. E., & Jaffe, A. S. (2002). Depression as a risk factor for cardiac mortality and morbidity: a review of potential mechanisms. J Psychosom Res, 53, 897–902.
Donker, F. J. S. (2000.) Cardiac Rehabilitation: A review of current development. Clinical Psychology Review, 20(7), 923-943.
Doraiswamy, P. M., Macfall, J., Krishnan, K. R. O, Connor, C., Wan, X., & Benaur, M. (1999). Magnetic resonance assessment of cerebral perfusion in depressed cardiac patient: Preliminary findings. American Journal of Psychiatry, 156, 1641-1643.
Druss, B. G., Bradford, D. W., Rosenheck, R. A., Radrofer, M. J., & Krumholz, H. M. (2000). Mental disorders and use of cardiovascular procedures after myocardial infarction, JAMA, 283(4), 506-511. doi:10.1001/jama.283.4.506.
Dusseldorp, E., Van Elderen, T., Maes, S., Meulman, J., Kraaij, V. (1999). A Mwta-Analysis of Psychoeducational Programs for Cronary Heart Disease Patients. Health Psychology, 18(5), 506-519.
Ghassemzadeh, H., Mojtabai, R., Karamghadiri, N., & Ebrahimkhani, N. (2005). Psychometric Properties of a Persian-Language Version of the Beck Depression Inventory Second Edition: BDI-II-Persian. Depression and Anxiety, 21, 185–192.
Goldston, K., & Bailie, A. (2008). Depression and coronary heart disease: A review of the epidemiological evidence explanatory mechanisms and management approaches. Clinical Psychology Review, 2, 288–306.
Gulliksson, M., Burell, G., Vessby, B., Lundin, L., Toss, H., & Svardsudd, K. (2011). Randomized Controlled Trial of Cognitive Behavioral Therapy vs Standard Reatment to Prevent Recurrent Cardiovascular Events in Patients with Coronary Heart Disease. Arch Intern Med. 171(2), 134-140.
Halford, J., & Brown, T. (2009). Cognitive-Behavioural Therapy as an adjunctive treatment in chronic physical illness. Advances in psychiatric treatment, 15, 306–317, doi: 10.1192/apt.bp.107.003731.
Khayam, M., Nekouei, Z., Yousefy, A., & Manshaee, G. (2012). Cognitive-behavioral therapy and quality of life: An experience among cardiac patients. Journal of Education and Health Promotion, 1, 1-4.
Laghrissi-Thode, F., Wagner, W. R., Pollock, B. G., Johnson, P. C., & Finkel, M. S. (1997). Elevated platelet factor 4 and β-thromboglobulin plasma levels in depressed patients with ischemic heart disease. Biological Psychiatry, 42, 290-295.
Lesperance, F., Frasure, N., Talajic, M., & Bourassa, M. G. (2002). Five year risk of cardiac mortality in relation to severity and one year changes in depression symptoms after myocardial infarction. Circulation, 105, 1049-1053. doi: 10.1161/ hc0902.104707.
Linden, W., Phillips, M. J., & Lecrec, J. (2007). Psychological treatment of cardiac patients: A meta-analysis. Eur Heart J (2007) 28 (24), 2972-2984. doi: 10.1093/ eurheartj/ehm504.
National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand. (2000). Management of unstable angina guidelines. Medical Journal of Australia, 173, 65-88.
Rees, K., Bennett, P., West, R., Davey Smith, G., & Ebrahim S. (2004). Psychological interventions for coronary heart disease. Cochrane Database of Systematic Reviews., Issue 2. Art. No.: CD002902. DOI: 10.1002/14651858.CD002902.pub2.
Rudish, B., & Nemeroff, C. B. (2003). Epidemiology of comorbid coronary artery disease and depression. Biological Psychiatry, 54, 227-40.
Rugulies, R. (2002). Depression as a predictor for coronary heart disease: A review and meta- analysis. American Journal of Preventive Medicine, 23, 51–61.
Ruo, B., Rumsfeld, J. S., Haltky, M. A., Liu, H., Browner, W. S., & Whooley, M. A. (2003). Depressive symptoms and health-related quality of life: the heart and soul study. JAMA, 290, 215–221.
Schins, A., Honig, A., Crijins, J., Baur, L., & Hamulak, K. (2003). Increased coronary events in depressed cardiovascular patients: 5-HT2A receptor as missing link? Psychosomatic Medicine, 65(5), 729-737.
Sebregts, E. W. J., Falger, P. R. J., Appels, A., Kester, A., & Baer, F. W. H. M. (2005). Psychological effects of a short behavior modification program in patients with acute myocardial infarction or coronary artery bypass grafting. A randomized controlled trial. Journal of Psychosomatic Research, 58(5), 417-424.
Tully, P. J., Baker, R. A., & Knight, J. L. (2008). Anxiety and depression as risk factors for mortality after coronary artery bypass surgery. Journal of Psychosomatic Research, 64(3), 285–290.
Weinger, K., Beverly, E. A., Lee, Y., & et al. (2012). Can a Cognitive Therapy Group Intervention Improve Glycemia in Patients with Poorly Controlled Diabetes? JCOM, 19(2), 56-59.
Whalley, B., Rees, K., Davies, P., Bennett, P., Ebrahim, S., Liu, Z., West, R., Moxham, T., Thompson, D. R., & Taylor, R. S. (2011). Psychological interventions for coronary heart disease. Cochrane Database of Systematic Reviews, Issue 8. Art. No.: CD002902. DOI: 10.1002/14651858.CD002902.pub3.
Wulsin, L. R. (2004). Is depression a risk factor for coronary heart disease? A systematic review of the epidemiologic evidence. Harv Rev Psychiatry, 12, 79-93.