Background/objective: Although demoralization is associated with morbidity and mortality in cardiac settings, its treatment has been overlooked. The present randomized controlled trial aimed at 1) evaluating the effectiveness of sequential combination of Cognitive-Behavioral and Well-Being therapies (CBT/WBT), compared to Clinical Management (CM), on demoralization among Acute Coronary Syndromes (ACS) patients, at post-treatment and after 3 months; 2) examining ACS patients' characteristics predicting demoralization persistence at 3-month follow-up. Method: 91 demoralized ACS patients were randomized to CBT/WBT (N = 47) or CM (N = 44). Demoralization was assessed with an interview on Diagnostic Criteria for Psychosomatics Research at baseline, post-treatment and 3-month follow-up. Predictors of demoralization maintenance included cardiac parameters, psychological distress and well-being. Results: Compared to CM, CBT/WBT significantly reduced demoralization post-treatment. Somatization (odds ratio = 1.11; p = 0.027) and history of depression (odds ratio = 5.16; p = 0.004) were risk factors associated with demoralization persistence at follow-up, whereas positive relationships (odds ratio = 0.94; p = 0.005) represented protective factors. Conclusions: The study provides preliminary and promising evidence on the benefits of CBT/WBT in treating demoralization in ACS patients. Moreover, ACS patients with somatization or positive history of depression could be at higher risk for developing persistent demoralization.

Demoralization in acute coronary syndrome: Treatment and predictive factors associated with its persistence / Gostoli, Sara; Subach, Regina; Guolo, Francesco; Buzzichelli, Sara; Abbate Daga, Giovanni; de Figueiredo, John M.; Rafanelli, Chiara. - In: INTERNATIONAL JOURNAL OF CLINICAL AND HEALTH PSYCHOLOGY. - ISSN 1697-2600. - ELETTRONICO. - 24:1(2024), pp. 100444.1-100444.8. [10.1016/j.ijchp.2024.100444]

Demoralization in acute coronary syndrome: Treatment and predictive factors associated with its persistence

Gostoli, Sara;Subach, Regina;Rafanelli, Chiara
2024

Abstract

Background/objective: Although demoralization is associated with morbidity and mortality in cardiac settings, its treatment has been overlooked. The present randomized controlled trial aimed at 1) evaluating the effectiveness of sequential combination of Cognitive-Behavioral and Well-Being therapies (CBT/WBT), compared to Clinical Management (CM), on demoralization among Acute Coronary Syndromes (ACS) patients, at post-treatment and after 3 months; 2) examining ACS patients' characteristics predicting demoralization persistence at 3-month follow-up. Method: 91 demoralized ACS patients were randomized to CBT/WBT (N = 47) or CM (N = 44). Demoralization was assessed with an interview on Diagnostic Criteria for Psychosomatics Research at baseline, post-treatment and 3-month follow-up. Predictors of demoralization maintenance included cardiac parameters, psychological distress and well-being. Results: Compared to CM, CBT/WBT significantly reduced demoralization post-treatment. Somatization (odds ratio = 1.11; p = 0.027) and history of depression (odds ratio = 5.16; p = 0.004) were risk factors associated with demoralization persistence at follow-up, whereas positive relationships (odds ratio = 0.94; p = 0.005) represented protective factors. Conclusions: The study provides preliminary and promising evidence on the benefits of CBT/WBT in treating demoralization in ACS patients. Moreover, ACS patients with somatization or positive history of depression could be at higher risk for developing persistent demoralization.
2024
Demoralization in acute coronary syndrome: Treatment and predictive factors associated with its persistence / Gostoli, Sara; Subach, Regina; Guolo, Francesco; Buzzichelli, Sara; Abbate Daga, Giovanni; de Figueiredo, John M.; Rafanelli, Chiara. - In: INTERNATIONAL JOURNAL OF CLINICAL AND HEALTH PSYCHOLOGY. - ISSN 1697-2600. - ELETTRONICO. - 24:1(2024), pp. 100444.1-100444.8. [10.1016/j.ijchp.2024.100444]
Gostoli, Sara; Subach, Regina; Guolo, Francesco; Buzzichelli, Sara; Abbate Daga, Giovanni; de Figueiredo, John M.; Rafanelli, Chiara
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/957658
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