Journal
PSYCHOSOMATIC MEDICINE
Volume 72, Issue 5, Pages 434-441Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PSY.0b013e3181d9bcec
Keywords
implantable cardioverter defibrillator; prevention of anxiety; randomized clinical trial
Categories
Funding
- Stiftung Begabtenforderung Cusanuswerk
- DFG [RTG 1253/1, FOR 605]
Ask authors/readers for more resources
Objective: To evaluate a minimal, easy, accessible intervention targeting anxiety and reduced quality of life in patients with an implantable cardioverter defibrillator (ICD). An estimated 24% to 87% of patients experience anxiety, and 10% to 15% have reduced quality of life. Methods: A total of 119 ICD patients were assigned randomly to usual medical aftercare (n = 63) or additional psychological treatment (n 56) comprising of written information on medical and psychological consequences of an ICD plus 6 months of individual phone counseling. Treatment efficacy was evaluated by comparing TO (immediately after implantation) and T1 (6 months later) assessments. Results: Although 75% of patients considered the program helpful, age moderated treatment efficacy. As indicated by triple interactions, only in the treatment group, anxiety (HADS-Anxiety, p < .01), psychological distress (SCL-K-9, p < .02), and somatic quality of life (SF-36-PCS, p < .01) improved in ICD patients aged <65 years but deteriorated in older patients (age, 65-75 years). Frequency of ICD discharges was associated with a symptom increase from TO to T1 in all patients (HADS-Depression, CAQ-Avoidance, and ICD-Constraints; all p < .05). Conclusions: Our findings confirm that psychological treatments cannot be expected to have uniformly positive effects in ICD patients. Our minimal intervention may have adequately addressed ICD-related concerns in younger patients but may have fostered problems in older patients with fewer concerns. Therefore, our findings warrant custom treatment with particular attention to the elderly as well as patients with frequent ICD discharges.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available