Gebhardt Philippa, Caldarone Flora, Westhoff-Bleck Mechthild, Olsson Karen M, Hoeper Marius M, Park Da-Hee, Stapel Britta, Breitner Michael H, Werth Oliver, Heitland Ivo, Kahl Kai G
Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Front Psychiatry. 2022 Apr 4;13:812807. doi: 10.3389/fpsyt.2022.812807. eCollection 2022.
Mental disorders are common among patients with severe cardiovascular diseases (CVD). Yet, there is a lack of easily accessible evidence-based treatments. Recent research indicates elevated prevalence of dysfunctional metacognitions in patients with mental disorders following cardiovascular events. As metacognitive therapy (MCT) is an established treatment to modify metacognitions, we tested if a brief metacognitive intervention videotelephony is effective in this patient group.
A brief MCT treatment was tailored to CVD patients and designed as a face-to-face internet-based intervention. Five patients with CVDs and comorbid mental disorders underwent a psychocardiological examination and diagnostic approach. Each patient participated in eight 50 min sessions encrypted video messenger service. Metacognitions, depression and anxiety symptoms and quality of life were assessed by self-report measures pre- and post-treatment. Patients rated dysfunctional thought processes, current psychological impairment, and treatment satisfaction after each session. Intended follow-up measures were not reported due to missing data.
For most patients, the brief metacognitive intervention was associated with a decrease in dysfunctional metacognitions and a reduction of symptoms of anxiety and depression post-treatment. Psychological and physiological quality of life improved. Patients reported high satisfaction with the tailored treatment.
Our results suggest that a brief internet-based metacognitive treatment may be a promising tool for patients with CVDs and comorbid mental disorders. Feasibility and acceptance of the intervention was rated high by the patients. Further research is necessary to support the preliminary findings and to adapt and evaluate the intervention in a controlled clinical trial setting.
精神障碍在重症心血管疾病（CVD）患者中很常见。然而，缺乏易于获得的循证治疗方法。最近的研究表明，心血管事件后精神障碍患者中功能失调性元认知的患病率有所上升。由于元认知疗法（MCT）是一种既定的用于改变元认知的治疗方法，我们测试了一种简短的元认知干预——视频电话干预对该患者群体是否有效。
针对CVD患者量身定制了一种简短的MCT治疗，并设计为基于互联网的面对面干预。五名患有CVD和共病精神障碍的患者接受了心理心脏学检查和诊断方法。每位患者通过加密视频信使服务参加了八次每次50分钟的疗程。在治疗前和治疗后通过自我报告措施评估元认知、抑郁和焦虑症状以及生活质量。患者在每次疗程后对功能失调的思维过程、当前的心理损害和治疗满意度进行评分。由于数据缺失，未报告预期的随访措施。
对于大多数患者而言，简短的元认知干预与治疗后功能失调性元认知的减少以及焦虑和抑郁症状的减轻相关。心理和生理生活质量得到改善。患者对量身定制的治疗表示高度满意。
我们的结果表明，一种简短的基于互联网的元认知治疗可能是患有CVD和共病精神障碍患者的一种有前景的工具。患者对该干预的可行性和接受度评价很高。需要进一步的研究来支持这些初步发现，并在对照临床试验环境中调整和评估该干预。
