CONTEXT: Depression is common after coronary artery bypass graft (CABG) surgery, but little is known about its effect on post-CABG inflammation or infection or about the most effective treatment for post-CABG depression. OBJECTIVES: (1) To determine ifpost-CABG depression is associated with increased infectious illness and (2) to test effects of cognitive behavioral therapy (CBT) on depressive symptoms, inflammatory biomarkers, and post-CABG infections in depressed post-CABG women. DESIGN: Randomized, controlled trial. SETTING:Two urban tertiary care centers. PATIENTS: Fifteen clinically depressed women in the first month after CABG, along with a comparison group of 37 non-depressed postCABG women, were studied. Inclusion criteria were: < or = 75 years old, English-speaking, undergoing first-time CABG, available for 6 months offollow-up, and without malignancy or autoimmune disorders. INTERVENTION: Eight weeks of individual home-based CBT. MAIN OUTCOME MEASURES: (1) Depressive symptoms measured by the Beck Depression Inventory, (2) natural killer cell cytotoxicity (NKCC) measured by 51Cr-release assay, (3) infectious illness episodes measured by the Modified Health Review, (4) interleukin (IL)-6 and C reactive protein (CRP) measured by enzyme immunoabsorbent assay. RESULTS: Clinically depressed post-CABG women exhibited decreased NKCC and a higher incidence of in-hospital fevers and infectious illness in the first 6 months after CABG. Among depressed women, CBT yielded moderate to large effects for improved NKCC (D=0.67) and decreased IL-6 (D=0.61), CRP (D=0.85), and postoperative infectious illnesses (D=0.93). CBT holds promise for improving depression and immunity and reducing infection and inflammation after CABG.
RCT Entities:
CONTEXT: Depression is common after coronary artery bypass graft (CABG) surgery, but little is known about its effect on post-CABG inflammation or infection or about the most effective treatment for post-CABG depression. OBJECTIVES: (1) To determine ifpost-CABG depression is associated with increased infectious illness and (2) to test effects of cognitive behavioral therapy (CBT) on depressive symptoms, inflammatory biomarkers, and post-CABG infections in depressed post-CABG women. DESIGN: Randomized, controlled trial. SETTING: Two urban tertiary care centers. PATIENTS: Fifteen clinically depressed women in the first month after CABG, along with a comparison group of 37 non-depressed postCABG women, were studied. Inclusion criteria were: < or = 75 years old, English-speaking, undergoing first-time CABG, available for 6 months offollow-up, and without malignancy or autoimmune disorders. INTERVENTION: Eight weeks of individual home-based CBT. MAIN OUTCOME MEASURES: (1) Depressive symptoms measured by the Beck Depression Inventory, (2) natural killer cell cytotoxicity (NKCC) measured by 51Cr-release assay, (3) infectious illness episodes measured by the Modified Health Review, (4) interleukin (IL)-6 and C reactive protein (CRP) measured by enzyme immunoabsorbent assay. RESULTS: Clinically depressed post-CABG women exhibited decreased NKCC and a higher incidence of in-hospital fevers and infectious illness in the first 6 months after CABG. Among depressed women, CBT yielded moderate to large effects for improved NKCC (D=0.67) and decreased IL-6 (D=0.61), CRP (D=0.85), and postoperative infectious illnesses (D=0.93). CBT holds promise for improving depression and immunity and reducing infection and inflammation after CABG.
Authors: Lemmy Schakel; Dieuwke S Veldhuijzen; Paige I Crompvoets; Jos A Bosch; Sheldon Cohen; Henriët van Middendorp; Simone A Joosten; Tom H M Ottenhoff; Leo G Visser; Andrea W M Evers Journal: Psychother Psychosom Date: 2019-08-06 Impact factor: 17.659
Authors: Elizabeth A Hoge; Eric Bui; Sophie A Palitz; Noah R Schwarz; Maryann E Owens; Jennifer M Johnston; Mark H Pollack; Naomi M Simon Journal: Psychiatry Res Date: 2017-01-26 Impact factor: 3.222
Authors: Rachel J Gordon; Alan D Weinberg; Francis D Pagani; Mark S Slaughter; Pat S Pappas; Yoshifumi Naka; Daniel J Goldstein; Walter P Dembitsky; Julie C Giacalone; Jennifer Ferrante; Deborah D Ascheim; Alan J Moskowitz; Eric A Rose; Annetine C Gelijns; Franklin D Lowy Journal: Circulation Date: 2013-01-11 Impact factor: 29.690