Modulatory effects of cognitive behavior therapy on depression and anxiety in patients with implantable cardioverter defibrillator / 中国组织工程研究

ABSTRACT

BACKGROUND: 60% of the patients receiving implantable cardioverter defibrillator(ICD) believe their quality of life has been improved. However,about 30% to 50% of the patients suffer from postoperative depression and anxiety; especially those patients receive electroconvulsive therapy (ECT).OBJECTIVE: To probe into the modulatory effects of cognitive behavior therapy(CBT) on depression and anxiety in patients with ICD.DESIGN: A retrospective case analysis based on ICD patients SETTING: Room of Cardiac Catheterization, Department of Cardiology, Xiangya Second Hospital PARTICIPANTS: The study was conducted in the Room of Cardiac Catheterization of the Department of Cardiology, Xiangya Second Hospital,Central South University from October 2000 to August 2001. Inclusive criteria ICD patients that had ineffective medicine therapy for paroxysmal ventricular tachycardia and/or ventricular fibrillation complicated with cardiac syncope. Exclusive criteria incoorperative patients or patients who unable to receive periodical follow up. A total of 6 patients were involved including 4 male and 2 female patients aged from 45 to 71 years old with an average age of (57.3 ± 2.4) years old. All of the patients received Micro Jewell Ⅱ 7223 ICD made by Medtronic Company. Diagnoses of basic disease2 cases of coronary heart disease, 2 cases of right ventricular myocardial disease, 1 case of paroxysmal ventricular tachycardia due to unknown reason,and 1 case of Brugada syndrome.METHODS: "Morita therapy" technique was used. Patients were asked to transfer their spirit energies into feasible objectives of their real life, which would be helpful to the rapid improvement of their symptoms. symptom checklist-90(SCL-90) scale was used to evaluate the psychological symptoms before and after the therapy.MAIN OUTCOME MEASURES: Comparison of the scores gained in SCL-90 between before and after CBT.RESULTS: There were significant differences in the items of somatization,compulsion, sensitive human relationship, depression, anxiety, phobia disorder, etc. between before and after CBT ( P ＜ 0.05 or 0.01 ).CONCLUSION: Psychotherapy shouldn't be neglected in the postoperative follow up of ICD, and CBT is helpful to relieve symptoms especially for those depression and anxiety patients with electroconvulsive experiences.