Coronary Artery Disease, Depressive Symptoms
Conditions
Keywords
Mindfulness Based Stress Reduction, Depressive symptoms, Coronary Artery Disease, Mastery
Brief summary
The Mindfulness Intervention as Myocardial Infarction Rehabilitation Additive (MIMIRA) study aimed at studying the feasibility and acceptability of Mindfulness Based Stress Reduction - an 8 week course in meditation and yoga - in patients with a recent coronary artery event and elevated depressive symptoms. To address these questions patients with elevated scores on a depression scale were invited to participate in MBSR, and there evaluation of the course as well as a panel of psychological risk factors and resources was measured.
Detailed description
Depressive symptomatology in patients with coronary artery disease (CAD) has prognostic importance. Yet, psychological interventions in clinical practice are scarce. Here, we explored the feasibility and acceptability of mindfulness-based stress reduction (MBSR) in patients with depressive symptoms after a recent coronary event. A second aim was to investigate psychological risk factors and resources among participants. To address the research questions, depressive symptoms were first measured in a reference population, at 1 and 12 months after a coronary event (myocardial infarction or unstable angina pectoris), and a cut-off for elevated depressive symptoms were obtained from the median in this group. Thereafter, similar CAD patients with elevated depressive symptoms (above median in the reference group), from the same outpatient clinic, were consecutively invited to an 8-week MBSR program. Serious physical or psychiatric illness that would be an obstacle to participation were exclusion criteria. Patients who completed the MBSR-course were asked to evaluate its various facets, and completion rate and attendance were feasibility outcomes. Psychological variables were measured before, after the course as well as 12 months later.
Interventions
An 8-week course in mindfulness meditation, yoga training and weekly group support in the form of weekly 2,5 hour meetings at the hospital.
Sponsors
Linkoeping University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
Pilot and feasibility study of one cohort.
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. Recent (within 12 month) first time coronary artery event; defined as a diagnosis of myocardial infarction or unstable angina pectoris addressed with either percutaneous coronary intervention (PCI) or coronary artery by-pass graft surgery (CABG). 2. Depressive symptoms above a score of 8 on the questionnaire centre for epidemiological studies depression scale (CES-D). 3. Interest for participation in MBSR.
Exclusion criteria
1. Major depression or other serious psychiatric illness (such as psychosis or ongoing life crisis). 2. Severe comorbidities, such as cancer, severe cognitive impairment and alcohol or drug abuse. 3. Practical hindrances for participation in MBSR.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility | Immediately after the 8-week intervention. | Patient evaluation questionnaire |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Anxiety | Before, immediately after and 12 months post intervention. | Generalized Anxiety Disorder Scale - 7 (GAD-7) questionnaire (Spitzer) |
| Mindfulness | Before, immediately after and 12 months post intervention. | Five Facets of Mindfulness Questionnaire (FFMQ) (Baer) |
| Acceptance | Before, immediately after and 12 months post intervention. | Acceptance and Action Questionnaire II (AAQII) (Block) |
| Depressive Symptoms | Before, immediately after and 12 months post intervention. | Centre for Epidemiological Studies Scale Depression (CES-D) questionnaire (Radloff) |
| Self-esteem | Before, immediately after and 12 months post intervention. | Self-esteem questionnaire (Rosenberg) |
| Patients experiences of mindfulness training | Continuously during the 8 week course. | Written journal entries (linguistic content) |
| Mastery | Before, immediately after and 12 months post intervention. | Mastery questionnaire (Pearlin & Shooler) |
Countries
Sweden
Outcome results
None listed