Effects of a Psychotherapy Intervention in Depressed Patients With Coronary Artery Disease
Effects of a Psychotherapy Intervention in Depressed Patients With Coronary Artery Disease
In patients with coronary artery disease (CAD), depressive symptoms are frequent and highly
 relevant for quality of life, health behaviour, health care costs, and prognosis. The aim of
 the current study is to evaluate the effects of a psychotherapy intervention on symptoms of
 depression in patients with CAD. Therefore, depressed patients diagnosed with CAD will be
 randomised into a controlled intervention trial, comparing a stepwise psychotherapy
 intervention with usual cardiological care. The manualized psychotherapy intervention starts
 with three individual sessions offered on a weekly basis. Afterwards, symptoms of depression
 will be re-evaluated and, in case of persisting symptoms, patients receive an additional 25
 sessions of psychodynamic group psychotherapy over a total period of one year. The
 psychodynamic approach was chosen in order to specifically take into account personality
 traits such as negative affectivity and social inhibition, the components of the Type D
 personality, which may explain why recent cognitive behavioural psychotherapy (CBT) trials
 produced only small effects in depressed CAD patients. The investigators expect that the
 intervention will reduce depressive symptoms as well as the prevalence of depressive
 disorders. It will also improve both behaviourally and physiologically mediated
 cardiovascular risk indicators, promote better quality of life, and reduce healthcare costs.
 Subgroup analyses will be performed in order to identify gender-specific treatment effects,
 effects on immunological stress reactivity, and genetic predictors of treatment success.
Inclusion Criteria:

 -  Patients with coronary artery disease

 -  German speaking men and women

 -  Recent coronary angiogram (<= 3 months old)

 -  Depression score (HADS-D) >= 8

 -  Written informed consent

 Exclusion Criteria:

 -  Severe heart failure

 -  Other acutely life- threatening conditions

 -  Severe chronic inflammatory disease

 -  Current suicidal tendency

 -  Severe depressive episode

 -  Other severe mental illness.