Cited by 228Cardiac Health and Mental HealthAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesCancer survivorship and care

The DOI matches its Crossref record, with a small difference in title or year; 71 of the 71 references it cites were found in a registry or an index.

Treatment of Depression After Coronary Artery Bypass Surgery: A Randomized Controlled Trial

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Abstract

CONTEXT: There has been little research on the treatment of depression after coronary artery bypass surgery. OBJECTIVE: To test the efficacy of 2 nonpharmacological interventions for depression after coronary artery bypass surgery compared with usual care. DESIGN: A 12-week, randomized, single-blind clinical trial with outcome evaluations at 3, 6, and 9 months. SETTING: Outpatient research clinic at Washington University School of Medicine, St Louis, Missouri. PATIENTS: One hundred twenty-three patients who met the DSM-IV criteria for major or minor depression within 1 year after surgery. INTERVENTION: Twelve weeks of cognitive behavior therapy or supportive stress management. Approximately half of the participants were taking nonstudy antidepressant medications. MAIN OUTCOME MEASURE: Remission of depression, defined as a score of less than 7 on the 17-item Hamilton Rating Scale for Depression. RESULTS: Remission of depression occurred by 3 months in a higher proportion of patients in the cognitive behavior therapy (71%) and supportive stress-management (57%) arms than in the usual care group (33%) (chi(2)(2) = 12.22, P = .002). Covariate-adjusted Hamilton scores were lower in the cognitive behavior therapy (mean [standard error], 5.5 [1.0]) and the supportive stress-management (7.8 [1.0]) arms than in the usual care arm (10.7 [1.0]) at 3 months. The differences narrowed at 6 months, but the remission rates differed again at 9 months (73%, 57%, and 35%, respectively; chi(2)(2) = 12.02, P = .003). Cognitive behavior therapy was superior to usual care at most points on secondary measures of depression, anxiety, hopelessness, stress, and quality of life. Supportive stress management was superior to usual care only on some of the measures. CONCLUSIONS: Both cognitive behavior therapy and supportive stress management are efficacious for treating depression after coronary artery bypass surgery, relative to usual care. Cognitive behavior therapy had greater and more durable effects than supportive stress management on depression and several secondary psychological outcomes. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00042198.

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Crossref · 10.1001/archgenpsychiatry.2009.7

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Authors
Freedland, K. E., Skala, J. A., Carney, R. M., Rubin, E. H., Lustman, P. J., Dávila-Román, V. G., Steinmeyer, B. C., & Hogue, C. W.
Affiliations
  • Washington University in St. Louis (US)
  • Johns Hopkins University (US)
Venue
Archives of General Psychiatry
Published
2009-04-01
Volume
66
Issue
4
Pages
387
ISSN
0003-990X (ISSN-L)
OpenAlex
W2020027855
Cited by
228
References
68
Citations by year
2026: 4 · 2025: 10 · 2024: 9 · 2023: 9 · 2022: 13 · 2021: 9 · 2020: 9 · 2019: 10 · 2018: 17 · 2017: 14 · 2016: 17 · 2015: 11 · 2014: 9 · 2013: 21 · 2012: 16
FWCI
13.59
Type
journal article
Language
en
Open access
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Heart, Lung, and Blood Institute (R01HL064600)
  • National Institute of Mental Health (R01MH060735, R21MH052629)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
postoperative depression, coronary artery bypass grafting, cognitive behavioral therapy, depression remission, anxiety, hopelessness, quality of life, cardiac surgery patients
MeSH terms
Aged, Coronary Artery Bypass, Counseling, Major Depressive Disorder, Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction, Personality Inventory, Postoperative Complications, Psychometrics, Social Support, Cognitive Behavioral Therapy, Single-Blind Method

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