The effect of psychological intervention on patients' long-term adjustment to the ICD: A prospective study

ORCID

Carolynn S. Kohn: 0000-0002-2156-4898

Document Type

Article

Publication Title

Pacing and Clinical Electrophysiology

Department

Psychology

ISSN

0147-8389

Volume

23

Issue

4

DOI

10.1111/j.1540-8159.2000.tb00826.x

First Page

450

Last Page

456

Publication Date

1-1-2000

Abstract

This study prospectively examined tbe role of cognitive behavioral therapy (CBT) in (1) alleviating psychological and somatic distress, and (2) lowering arrhythmic events requiring shocks. Forty-nine of 61 consecutive patients were randomized into therapy (CBT, n = 25) or no therapy (NT, n = 24) and completed a battery of self-report questionnaires at baseline and at Q-month follow-up. CBT was administered at preimplant, predischarge, and at seven routine follow-up visits. Patients were 65 ± 10 years old. 65% were men. and 92% Caucasian. Eighteen (72%) CBT patients and 18 (75%) NT patients were retained at follow-up. Compared to CBT patients. NT patients reported higher levels of depression (P = 0.046), more anxiety (P = 0.013), more psychological distress (P = 0.015), poorer overall adjustment (P = 0.009), and poorer sexual functioning (P = 0.003). Mean number of shocks did not differ between the CBT and NT groups (2.85 vs 2.30. respectively): however, more patients in the CBT group (61%) than the NT group (33%) received shocks (P = 0.070). At follow-up, a subgroup analysis revealed that the significant differences observed between the CBT and NT groups were attributable to the patients who received shocks in both groups. In conclusion, CBT was associated with decreased depression, decreased anxiety, and increased adjustment for ICD recipients, particularly among those patients receiving shocks. CBT can be administered effectively at routine follow-up visits or transtelephonically with little added inconvenience to the ICD recipient.

This document is currently not available here.

Share

COinS