A New CBT Model of Panic Attack Treatment in Comorbid Heart Diseases (PATCHD): How to Calm an Anxious Heart and Mind

Tully, Phillip J.; Sardinha, Aline; Nardi, Antônio Egídio

doi:10.1016/j.cbpra.2016.05.008

Cited by 25 publications

(21 citation statements)

References 61 publications

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“…Evidence-based PT is also not available as standard CBT for anxiety disorders (including exposure therapy) can have adverse somatic effects in CAD patients ( 34 – 37 ), and no adaptation for this patient population has yet been implemented. However, the PATCHD trial recently proved feasibility of such an adaption ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although anxiety disorders are as common in CAD patients as depressive disorders (unpublished data), research on their treatment is even scarcer ( 14 ). Panic disorder was successfully treated in CAD patients in the small PATCHD trial ( 15 ) and additional CBT reduced somatic anxiety in the SUPRIM trial ( 12 , 13 ). In addition, little is known about the utilization rates of mental health-care services by patients with CAD and comorbid affective or anxiety disorders, as well as about effectiveness of general mental health care in CAD patients outside of the research setting.…”

Section: Introductionmentioning

confidence: 99%

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Utilization of Mental Health Care, Treatment Patterns, and Course of Psychosocial Functioning in Northern German Coronary Artery Disease Patients with Depressive and/or Anxiety Disorders

et al. 2018

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BackgroundComorbid mental disorders in patients with coronary artery disease (CAD) are common and associated with adverse somatic outcomes. However, data on utilization rates of mental health care and treatment efficiency are scarce and inconsistent, which we tried to remedy with the present preliminary study on Northern German CAD patients.MethodA total of 514 German CAD patients, as diagnosed by cardiac catheterization, were assessed using the Mini International Neuropsychiatric Interview and the Global Assessment of Functioning (GAF) scale.ResultsGlobal utilization of mental health care since onset of CAD was 21.0%. Depressive disorders, younger age, and lower GAF at onset of CAD were associated with higher utilization rates, while anxiety disorders and gender were not. Lower GAF at onset of CAD, female gender, and psychotherapy was positively associated with higher gains in GAF, while younger age and anxiety disorders were negatively associated.ConclusionThe majority of CAD patients with comorbid depression reported to have received mental health treatment and seemed to have benefited from it. However, we found preliminary evidence of insufficiencies in the diagnosis and treatment of anxiety disorders in CAD patients. Further studies, preferably prospective and with representative samples, are needed to corroborate or falsify these findings and explore possible further mediators of health-care utilization by CAD patients such as race, ethnicity, and socioeconomic status.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Utilization of Mental Health Care, Treatment Patterns, and Course of Psychosocial Functioning in Northern German Coronary Artery Disease Patients with Depressive and/or Anxiety Disorders

et al. 2018

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“…Several effective evidence-based supports are available to assist patients to manage anxiety and depression, underscoring the importance of early identification of at-risk patients. Cognitive behaviour therapy (CBT) has been shown to be effective in reducing anxiety and depression in cardiac patients (Ski et al, 2016;Tully et al, 2017), as has cost-effective short term psychotherapy (Pristipino et al, 2019) and low intensity collaborative care (Huffman et al, 2014). Selective serotonin reuptake inhibitors (SSRIs) are effective for cardiac patients with depression, both for remission of depressive symptoms (Thombs et al, 2008;Pizzi et al, 2011;Kim et al, 2018) and reduced incidents of re-events and death (Taylor et al, 2005;Kim et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Anxiety and Depression After a Cardiac Event: Prevalence and Predictors

et al. 2020

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Introduction: Patients who are anxious or depressed after an acute cardiac event are at increased risk of a subsequent event and premature death. It is therefore important to identify these patients early in order to initiate supportive or even preventive measures. In the present study, we report on the prevalence of anxiety and depression during the first 12 months after an acute cardiac event, and the patient characteristics predictive of increased anxiety and depression risk in early and late convalescence. Methods: We recruited a sample of 911 patients with acute myocardial infarction (AMI), acute coronary syndrome (ACS), and/or unstable angina (UA), and/or undergoing coronary artery bypass graft surgery (CABGS). Patients completed the Hospital Anxiety and Depression Scale (HADS) close to the time of their event, and again during early (2-4 months post-event) and late (6-12 months post-event) convalescence. Using HADS-A and HADS-D cutoffs of 8+, prevalence rates for anxiety, depression, and comorbid anxiety and depression were determined for each timepoint. Chi-square tests and odds ratios were used to identify baseline patient characteristics associated with increased anxiety and depression risk over 12 months. Results: Anxiety rates were 43, 28, and 27% at the time of the event, early, and late convalescence. Depression rates were 22, 17, and 15%, respectively. Factors consistently associated with increased anxiety and depression risk were history of depression, financial strain, poor self-rated health, low socioeconomic status, younger age (<55 years), and smoking. Obesity, diabetes, and social isolation (living alone or being unpartnered) were identified as important albeit less significant risk factors. Neither sex nor event type were predictive of anxiety or depression. Conclusion: This large patient sample provided the opportunity to identify rates of anxiety and depression during the 12 months after a cardiac event and key patient characteristics for increased risk. These risk factors are easily identifiable at the time of the event, and could be used to guide the targeting of support programs for patients at risk.

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“…Indeed, cognitive-behavioral treatment (CBT) for addressing anxiety and fear in patients with cardiopulmonary disease can be challenging given the significant overlap in cardiac and pulmonary symptoms and symptoms of anxiety. [10][11] Therefore, increased scholarly attention to nuanced aspects of patients' fears and practitioners' understanding of such fears has the potential to bolster treatment development efforts. We examined fear about exercise and avoidance behaviors in patients enrolled in outpatient CVPR, and practitioners' beliefs and behaviors related to anxiety and fear about exercise.…”

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confidence: 99%

Anxiety and Fear of Exercise in Cardiopulmonary Rehabilitation

Farris

Abrantes

Bond

et al. 2019

Journal of Cardiopulmonary Rehabilitation and Prevention

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Purpose: One unexplored mechanism for poor outcomes in cardiovascular and pulmonary rehabilitation (CVPR) is fear about aerobic exercise. Patients in CVPR may tend to avoid aerobic exercise due to fearful of physical sensations associated with exertion. This study examined fear about exercise in patients enrolled in outpatient CVPR and practitioners' beliefs and behaviors related to fear associated with exercise. Methods: Survey data were collected from patients (N=117) enrolled in cardiac rehabilitation (CR; n=69) and pulmonary rehabilitation (PR; n=48), and practitioners (n=16) who were exercise physiologists and nurses working in CVPR. Results: Fears about exercise and avoidance behaviors were common among patients. In PR, fears and avoidance of exercise were correlated with higher levels of anxiety and depression (r's = .27-.54), lower FEV 1 /FVC (r's = −.13 to −.39), lower health-related quality of life (r's = −.13to .62), and stronger beliefs about utility of anxiety treatment (r's = .21-.36). In CR, fears about exercise were correlated with higher levels of anxiety (r's = .19-.38), lower mental health quality of life (r's = −.25 to −.27), and stronger beliefs about utility of anxiety treatment (r's = .30-.40), and avoidance of exercise was correlated with lower exercise tolerance and poorer physical health quality of life (r's = −.22 to −.24). Practitioners estimated that an average of 47 ± 20% of patients

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A New CBT Model of Panic Attack Treatment in Comorbid Heart Diseases (PATCHD): How to Calm an Anxious Heart and Mind

Cited by 25 publications

References 61 publications

Utilization of Mental Health Care, Treatment Patterns, and Course of Psychosocial Functioning in Northern German Coronary Artery Disease Patients with Depressive and/or Anxiety Disorders

Utilization of Mental Health Care, Treatment Patterns, and Course of Psychosocial Functioning in Northern German Coronary Artery Disease Patients with Depressive and/or Anxiety Disorders

Anxiety and Depression After a Cardiac Event: Prevalence and Predictors

Anxiety and Fear of Exercise in Cardiopulmonary Rehabilitation

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