Comparison of the Effects of Religious Cognitive Behavioral Therapy (RCBT), Cognitive Behavioral Therapy (CBT), and Sertraline on Depression and Anxiety in Patients after Coronary Artery Bypass Graft Surgery: Study Protocol for a Randomized Controlled Tri
-
Seyed Hamzeh Hosseini
,
Alireza Rafiei
,
Ali Gaemian
,
Abdolhakim Tirgari
,
Aliasghar Zakavi
,
jamshid Yazdani
,
Jafar Bolhari
,
Mahmood Golzari
,
Zahra Esmaeili Douki
,
Nazanin Vaezzadeh
Abstract
Objectives: Our objective is to compare the effects of RCBT, CBT, and sertraline on depression, anxiety, biomarker levels, and the quality of life in patients after coronary artery bypass graft (CABG) surgery.
Method/Design: This is a randomized controlled trial with parallel groups. A total of 160 patients after CABG surgery will be screened for anxiety and depression according to clinical interviews based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and Hospital Anxiety Depression Scale (HADS) scores (≥ 8). To assess religious attitude, Golriz and Baraheni’s religious attitude questionnaire will be used. Participants will be randomly allocated to four groups of 40 including three intervention groups (RCBT, CBT, and sertraline) and one control group (usual care). RCBT and CBT programs will consist of 12 one-hour weekly sessions. The participants in the pharmacological intervention group will receive 25-200 mg/d of sertraline for three months. The (SF-36) will be administered to assess the patients’ quality of life. Blood samples will be taken and biomarker levels will be determined using the enzyme-linked immunosorbent assay (ELISA). The primary outcome will be the reduction in anxiety and depression scores after the interventions. The secondary outcomes will be increases in quality of life scores and normalized biomarker levels after the interventions.
Discussion: If RCBT is found to be more effective than the other methods, it can be used to improve patients’ health status after CABG surgery.
Irct ID: IRCT201404122898N5
Birim Ö, Bogers A, Kappetein AP. Comparing cost aspects of coronary artery bypass graft surgery with coronary artery stenting. J Cardiovasc Surg 2012; 53: 641-650.
Mohr FW, Morice M-C, Kappetein AP, Feldman TE, Ståhle E, Colombo A, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. Lancet 2013; 381: 629-638.
Seldenrijk A, Vogelzangs N, Batelaan NM, Wieman I, van Schaik DJ, Penninx BJ. Depression, anxiety and 6-year risk of cardiovascular disease. J Psychosom Res 2015; 78: 123-129.
Celano CM, Daunis DJ, Lokko HN, Campbell KA, Huffman JC. Anxiety disorders and cardiovascular disease. Curr Psychiatry Rep 2016; 18: 101.
Tully PJ, Harrison NJ, Cheung P, Cosh S. Anxiety and Cardiovascular Disease Risk: a Review. Curr Cardiol Rep 2016; 18: 120.
Strik JJ, Denollet J, Lousberg R, Honig A. Comparing symptoms of depression and anxiety as predictors of cardiac events and increased health care consumption after myocardial infarction. J Am Coll Cardiol 2003 19; 42:1801-1807.
Tully PJ, Baumeister H, Bennetts JS, Rice GD, Baker RA. Depression screening after cardiac surgery: a six month longitudinal follow up for cardiac events, hospital readmissions, quality of life and mental health. Int J Cardiol 2016; 206: 44-50.
Stenman M, Holzmann MJ, Sartipy U. Relation of major depression to survival after coronary artery bypass grafting. Am J Cardiol 2014; 114: 698-703.
Connerney I, Sloan RP, Shapiro PA, Bagiella E, Seckman C. Depression is associated with increased mortality 10 years after coronary artery bypass surgery. Psychosom Med 2010; 72: 874-881.
Celano CM, Millstein RA, Bedoya CA, Healy BC, Roest AM, Huffman JC. Association between anxiety and mortality in patients with coronary artery disease: A meta-analysis. Am Heart J 2015; 170: 1105-1115.
Goyal TM, Idler EL, Krause TJ, Contrada RJ. Quality of life following cardiac surgery: impact of the severity and course of depressive symptoms. Psychosom Med 2005; 67: 759-765.
Glassman AH, Bigger JT, Gaffney M. Psychiatric characteristics associated with long-term mortality among 361 patients having an acute coronary syndrome and major depression: seven-year follow-up of SADHART participants. Arch Gen Psychiatry 2009; 66: 1022-1029.
Empana J, Sykes D, Luc G, Juhan-Vague I, Arveiler D, Ferrieres J, et al. Contributions of depressive mood and circulating inflammatory markers to coronary heart disease in healthy European men. Circulation 2005; 111: 2299-2305.
Dowlati Y, Herrmann N, Swardfager W, Liu H, Sham L, Reim EK, et al. A meta-analysis of cytokines in major depression. Biol Psychiatry 2010; 67: 446-457.
McCraty R, Barrios-Choplin B, Rozman D, Atkinson M, Watkins AD. The impact of a new emotional self-management program on stress, emotions, heart rate variability, DHEA and cortisol. Integr Physiol Behav Sci 1998; 33: 151-170.
Heaney JL, Phillips AC, Carroll D. Ageing, depression, anxiety, social support and the diurnal rhythm and awakening response of salivary cortisol. Int J Psychophysiol 2010; 78: 201-208.
Whooley MA, Caska CM, Hendrickson BE, Rourke MA, Ho J, Ali S. Depression and inflammation in patients with coronary heart disease: findings from the Heart and Soul Study. Biol Psychiatry 2007; 62: 314-320.
Tully PJ, Baker RA, Turnbull D, Winefield H. The role of depression and anxiety symptoms in hospital readmissions after cardiac surgery. J Behav Med 2008; 31: 281-290.
Murphy BM, Elliott PC, Higgins RO, Le Grande MR, Worcester MU, Goble AJ, et al. Anxiety and depression after coronary artery bypass graft surgery: most get better, some get worse. Eur J Cardiovasc Prev Rehabil 2008; 15: 434-440.
Schuurmans J, Comijs H, Emmelkamp PM, Gundy CM, Weijnen I, Van Den Hout M, et al. A randomized, controlled trial of the effectiveness of cognitive–behavioral therapy and sertraline versus a waitlist control group for anxiety disorders in older adults. Am J Geriatr Psychiatry 2006; 14: 255-263.
O'Connor CM, Jiang W, Kuchibhatla M, Silva SG, Cuffe MS, Callwood DD, et al. Safety and efficacy of sertraline for depression in patients with heart failure: results of the SADHART-CHF (Sertraline Against Depression and Heart Disease in Chronic Heart Failure) trial. J Am Coll Cardiol 2010; 56: 692-699.
Hersen M, Van Hasselt VB. Behavioral assessment and treatment of anxiety in the elderly. Clinical Psychology Review 1992; 12: 619-640.
Rizzo M, Creed F, Goldberg D, Meader N, Pilling S. A systematic review of non-pharmacological treatments for depression in people with chronic physical health problems. J Psychosom Res 2011; 71: 18-27.
Beltman MW, Voshaar RCO, Speckens AE. Cognitive–behavioural therapy for depression in people with a somatic disease: Meta-analysis of randomised controlled trials. Br J Psychiatry 2010; 197: 11-19.
Gulliksson M, Burell G, Vessby B, Lundin L, Toss H, Svärdsudd K. Randomized controlled trial of cognitive behavioral therapy vs standard treatment to prevent recurrent cardiovascular events in patients with coronary heart disease: Secondary Prevention in Uppsala Primary Health Care project (SUPRIM). Arch Intern Med 2011; 171: 134-140.
Freedland KE, Skala JA, Carney RM, Rubin EH, Lustman PJ, Dávila-Román VG, et al. Treatment of depression after coronary artery bypass surgery: a randomized controlled trial. Arch Gen Psychiatry 2009; 66: 387-396.
Dekker RL. Cognitive therapy for depression in patients with heart failure: a critical review. Heart Fail Clin 2011; 7: 127-141.
Koenig HG. Religious versus conventional psychotherapy for major depression in patients with chronic medical illness: rationale, methods, and preliminary results. Depress Res Treat 2012; 2012: 460419.
Hamid N, Beshlideh K, Aedi BM, Dehghanzadeh Z. [A study of the effect of religion-based cognitive-behavior therapy on depression in divorced women (persian)]. Journal Of Family Counseling & Psychotherapy 2011; 1: 54-64.
Razali S, Hasanah C, Aminah K, Subramaniam M. Religious—sociocultural psychotherapy in patients with anxiety and depression. Aust N Z J Psychiatry 1998; 32: 867-872.
Pearce MJ, Koenig HG, Robins CJ, Nelson B, Shaw SF, Cohen HJ, et al. Religiously integrated cognitive behavioral therapy: A new method of treatment for major depression in patients with chronic medical illness. Psychotherapy (Chic) 2015; 52: 56-66.
Koenig HG, Pearce MJ, Nelson B, Daher N. Effects Of Religious Versus Standard Cognitive‐Behavioral Therapy On Optimism In Persons With Major Depression And Chronic Medical Illness. Depress Anxiety 2015; 32: 835-842.
Koenig HG, Pearce MJ, Nelson B, Erkanli A. Effects on Daily Spiritual Experiences of Religious Versus Conventional Cognitive Behavioral Therapy for Depression. J Relig Health 2016; 55: 1763-1777.
Koenig HG, Pearce MJ, Nelson B, Shaw SF, Robins CJ, Daher NS, et al. Religious vs. conventional cognitive behavioral therapy for major depression in persons with chronic medical illness: A pilot randomized trial. J Nerv Ment Dis 2015; 203: 243-251.
Daher N, Koenig HG, Pearce MJ, Nelson B, Shaw SF, Berk LS, et al. Effects of Religious vs. Conventional Cognitive-Behavioral Therapy on Purpose in Life in Clients with Major Depression and Chronic Medical Illness: A Randomized Clinical Trial. International Journal of Existential Psychology and Psychotherapy 2016; 6: 1-16.
Berk LS, Bellinger DL, Koenig HG, Daher N, Pearce MJ, Robins CJ, et al. Effects of Religious vs. Conventional Cognitive-Behavioral Therapy on Inflammatory Markers and Stress Hormones in Major Depression and Chronic Medical Illness: A Randomized Clinical Trial. Open Journal of Psychiatry 2015; 5: 238-259.
Bellinger DL, Berk LS, Koenig HG, Daher N, Pearce MJ, Robins CJ, et al. Religious involvement, inflammatory markers and stress hormones in major depression and chronic medical illness. Open Journal of Psychiatry 2014; 4: 335-352.
Kéri S, Szabó C, Kelemen O. Blood biomarkers of depression track clinical changes during cognitive-behavioral therapy. J Affect Disord 2014; 164: 118-122.
Sharifi V, Asadi S, Mohammadi M, AMINI H, Kaviani H, Semnani Y, et al. [Reliability And Feasibility of The Persian Version of The Structured Diagnostic Interview For DSM-IV (SCID) (Persian)]. Advances In Cognitive Science 2004; 6: 10-22.
Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health Qual Life Outcomes 2003; 1: 14.
Sadeghi MR, Bagherzadeh Ladari R, Haghshenas M. [A study of religious attitude and mental health in students of Mazandaran University of Medical Sciences (persian)]. Journal of Mazandaran University of Medical Sciences 2010; 20: 71-75.
Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Qual Life Res 2005; 14: 875-882.
Shooshtari MH, Davari-Ashtiani R, Shahrivar Z, Shabani A, Semnani Y, Kaviani H, et al. Structured clinical interview for DSM-IV (SCID Persian translation and cultural adaptation). Iran J Psychiatry 2007; 2: 46-48.
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale: an updated literature review. J Psychosom Res 2002; 52: 69-77.
Gandek B, Ware JE, Aaronson NK, Alonso J, Apolone G, Bjorner J, et al. Tests of data quality, scaling assumptions, and reliability of the SF-36 in eleven countries: results from the IQOLA Project. J Clin Epidemiol 1998; 51: 1149-1158.
Beck JS. Cognitive behavior therapy: Basics and beyond. Guilford Press; 2011.
| Files | ||
| Issue | Vol 12 No 3 (2017) | |
| Section | Original Article(s) | |
| Keywords | ||
| Religious Cognitive Behavioral Therapy Cognitive Behavioral Therapy Sertraline Anxiety Depression Biomarker | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
