Liaison Psychiatry Department, John Hunter Hospital, Hunter Region Mail Centre, NSW 2310, Australia.
Aust N Z J Psychiatry. 2009 Dec;43(12):1171-7. doi: 10.3109/00048670903270415.
In a general medical hospital with limited mental health resources, a clinical need arose for an effective treatment for depression and anxiety symptoms in cardiac rehabilitation patients.
A total of 628 cardiac rehabilitation outpatients at a tertiary care centre were screened with the Hospital Anxiety and Depression Scale at week 4 of their programme, and 182 of 558 responders (33%) scored > or =8 on the Depression and/or Anxiety subscales. A 6 week group cognitive behaviour therapy programme was developed to assist these identified patients. The resulting programme, BraveHeart, was piloted on 39 patients still experiencing significant symptoms of depression or anxiety at the end of rehabilitation. Patients were assessed at baseline, after treatment, 1 and 6 months after treatment using the Hospital Anxiety and Depression Scale and the Beck Depression Inventory-II.
Significant improvement in levels of depression and anxiety symptoms occurred from baseline to post-treatment assessment, and this change was maintained at 6 months, with moderate-strong effect sizes. Feedback from the group members was positive.
A specialized group treatment programme for cardiac patients with existing depression and anxiety was created that resulted in significant reductions in symptoms.
在一家精神卫生资源有限的综合医院,临床需要一种针对心脏康复患者抑郁和焦虑症状的有效治疗方法。
在一家三级护理中心,628 名心脏康复门诊患者在其治疗计划的第 4 周接受了医院焦虑和抑郁量表(HADS)的筛查,在 558 名应答者中,有 182 名(33%)在抑郁和/或焦虑分量表上的得分≥8。针对这些确定的患者,开发了一个为期 6 周的团体认知行为治疗方案。由此产生的方案“勇敢的心”(BraveHeart)在康复结束时仍有明显抑郁或焦虑症状的 39 名患者中进行了试点。在基线、治疗后、治疗后 1 个月和 6 个月,使用医院焦虑和抑郁量表(HADS)和贝克抑郁量表第二版(BDI-II)对患者进行评估。
抑郁和焦虑症状的严重程度从基线到治疗后评估均显著改善,这种变化在 6 个月时仍保持不变,且具有中度至强的效果量。小组成员的反馈是积极的。
为存在抑郁和焦虑的心脏患者创建了专门的团体治疗方案,显著减轻了他们的症状。