Effects of Internet-delivered cognitive behavioural therapy adapted for patients with cardiovascular disease and depression: a long-term follow-up of a randomized controlled trial at 6 and 12 months posttreatment
Open accessAbstract
BACKGROUND: Internet-based cognitive behavioural treatment (iCBT) has shown positive short-term effects on depression in patients with cardiovascular disease (CVD). However, knowledge regarding long-term effects and factors that may impact the effect of iCBT is lacking. AIMS: This study therefore sought (i) to evaluate the effect of iCBT on depression in CVD patients at 6- and 12-month follow-ups and (ii) to explore factors that might impact on the effect of iCBT on change in depression at 12-month follow-up. METHODS AND RESULTS: A longitudinal follow-up study of a randomized controlled trial evaluating the effects of a 9-week iCBT programme compared to an online discussion forum (ODF) on depression in CVD patients (n = 144). After 9 weeks, those in the ODF group were offered the chance to take part in the iCBT programme. The Patient Health Questionnaire (PHQ-9) and the Montgomery-Åsberg Depression Rating Scale-self-rated version (MADRS-S) measured depression at baseline, 9 weeks, 6 months, and 12 months. Linear mixed model and multiple regression analysis were used for statistical computing. The iCBT programme significantly improved depression at 9-week follow-up and this was stable at 6- and 12-month follow-ups (PHQ-9 P = 0.001, MADRS-S P = 0.001). Higher levels of depression at baseline and a diagnosis of heart failure were factors found to impact the effect of iCBT on the change in depression. CONCLUSION: A 9-week iCBT programme in CVD patients led to long-term improvement in depression. Higher levels of depression scores at baseline were associated with improvement in depression, whereas heart failure had opposite effect. CLINICAL TRIAL: The trial is registered at ClinicalTrials.gov, NCT02778074.
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- Authors
- Westas, M., Lundgren, J., Andersson, G., Mourad, G., & Johansson, P.
- Affiliations
- Linköping University (SE)
- Corresponding author
- Westas, Mats
- Venue
- European Journal of Cardiovascular Nursing
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-01-21
- Volume
- 21
- Issue
- 6
- Pages
- 559-567
- ISSN
- 1474-5151 (ISSN-L)
- 1873-1953
- OpenAlex
- W4205758469
- Cited by
- 22
- References
- 45
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 8 · 2023: 7
- FWCI
- 3.36
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Journal of Cardiovascular Nursing (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Swedish Research Council (2015-02600)
- ALF grants Region Östergötland (LIO-600321, LIO-687531)
- Region Östergötland, Strategical fund (LIO-719561)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- 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
- Keywords
- internet-based cognitive behavioral therapy, depression, cardiovascular disease, heart failure, long-term follow-up, online forums, treatment response factors, baseline depression severity, PHQ-9
- MeSH terms
- Cardiovascular Diseases, Depression, Follow-Up Studies, Heart Failure, Humans, Cognitive Behavioral Therapy, Treatment Outcome, Internet
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