Sebregts Ellen H W J, Falger Paul R J, Appels Ad, Kester Arnold D M, Bär Frits W H M
Department of Medical, Clinical and Experimental Psychology, Maastricht University, The Netherlands.
J Psychosom Res. 2005 May;58(5):417-24. doi: 10.1016/j.jpsychores.2004.02.021.
The effects of a short intervention on behavioral risk factor modification in patients with coronary artery disease (CAD) on Type A behavior, vital exhaustion, and depression were studied in a randomized controlled trial.
Acute myocardial infarction patients or patients who underwent coronary artery bypass grafting (CABG) were randomly assigned to an 8-week multiple risk modification group program (n = 94) or to a control group (n = 90) that received usual care with standard physical exercise training. Patients were assessed before intervention, directly after intervention, and at 9-month follow-up.
The intervention was effective in reducing hostility and total Type A behavior at postintervention (P = .01) and at 9-month follow-up (P = .03). The intervention had no overall impact on vital exhaustion and depression, measured by the Beck Depression Inventory (BDI), whereas we unexpectedly found that the percentage of patients with major depression was reduced in the control group but not in the intervention group.
The results indicate that a short behavioral intervention for coronary patients can result in relatively large and persistent reductions in cognitive aspects of Type A behavior and hostility, in particular. In view of the unwanted findings on the diagnosis of depression, however, we do not unequivocally advise the intervention to the general population of AMI and CABG patients.
在一项随机对照试验中，研究了短期干预对冠心病（CAD）患者A型行为、精疲力竭和抑郁等行为危险因素改变的影响。
将急性心肌梗死患者或接受冠状动脉旁路移植术（CABG）的患者随机分为8周多危险因素改善组（n = 94）或接受标准体育锻炼常规护理的对照组（n = 90）。在干预前、干预后即刻以及9个月随访时对患者进行评估。
干预在干预后（P = .01）和9个月随访时（P = .03）有效降低了敌意和总体A型行为。通过贝克抑郁量表（BDI）测量，干预对精疲力竭和抑郁没有总体影响，然而，我们意外地发现对照组中重度抑郁症患者的比例降低了，而干预组中没有。
结果表明，对冠心病患者进行短期行为干预尤其能导致A型行为和敌意的认知方面出现相对较大且持续的降低。然而，鉴于在抑郁症诊断方面的意外发现，我们并不明确建议对急性心肌梗死和冠状动脉旁路移植术患者的总体人群进行该干预。
