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The effect of guided web-based cognitive behavioral therapy on patients with depressive symptoms and heart failure- a randomized controlled tria
Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
2016 (English)In: European Journal of Heart Failure Abstracts Supplement, 2016, Vol. 18, 401- p., 8Conference paper, Poster (Refereed)
Abstract [en]

Background: Depressive symptoms, and the associated coexistence of symptoms of anxiety and decreased quality of life (QoL), are a common problem in patients with heart failure (HF). However, treatment strategies for depressive symptoms in patients with HF still remain to be established. Cognitive behavioral therapy (CBT) and its Internet-based version as guided self-help CBT programs (ICBT) have shown good effects in the treatment of depression, but ICBT has not previously been evaluated in patients with HF and depressive symptoms. Objective: The aims of this study were to: (I) evaluate the effect of a nine-week ICBT program on depressive symptoms in patients with HF; (II) to assess factors associated with the change in depressive symptoms; and (III) to investigate the effect of the ICBT program on cardiac anxiety and QoL. Methods: Fifty participants were included and randomized into two treatment arms: ICBT or an online moderated discussion forum (DF). The Patient Health Questionnaire -9 (PHQ-9) was used to measure depressive symptoms, the Cardiac Anxiety Questionnaire (CAQ) was used to measure cardiac-related anxiety, and the Minnesota Living with Heart Failure questionnaire (MLHF) was used to measure QoL. Data were collected at baseline and at the nine-week follow-up. Results: In the ICBT group, depressive symptoms (M=10.8 vs. M=8.6, P=.02) and cardiac anxiety in the subscale of fear (M=1.55 vs. M=1.35, P=.04) improved significantly. QoL improved in the ICBT group by 6 points in the total score and 2.4 points in the physical factor, but this was not significant (P=.09 and P=.12). In the DF group, only a small reduction in the level of depressive symptoms was detected (M =10.6 SD=5.0, vs. M=9.8 SD=4.3, P=.36). Despite improvement in the ICBT group this was not significantly different compared to the DF group (ANCOVA analyses: depressive symptoms, P=.21; cardiac-related anxiety subscale of fear, P=.22; QoL total scale score, P=.09 and physical factors, P=.07). In the ICBT group, the number of logins to the web-portal correlated significantly with improvement in depressive symptoms (P=.02), whereas higher age (P=.01) and male sex (P=.048) were associated with less change in depressive symptoms. Conclusions: Guided ICBT adapted for persons with HF and depressive symptoms can potentially reduce depressive symptoms, cardiac anxiety and increased QoL, but is not statistically superior to participation in an online discussion forum

Place, publisher, year, edition, pages
2016. Vol. 18, 401- p., 8
National Category
URN: urn:nbn:se:liu:diva-130549OAI: diva2:952829
Heart Failure 2016
Available from: 2016-08-15 Created: 2016-08-15 Last updated: 2016-08-22

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Lundgren, Johan Gustav
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Division of Nursing ScienceFaculty of Medicine and Health Sciences

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