Safety and Efficacy of Cognitive Behavior Therapy for People With Post-traumatic Stress and Cardiovascular Illness

NCT ID: NCT00364910

Last Updated: 2017-12-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-04-30

Study Completion Date

2008-04-30

Brief Summary

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This study will evaluate the safety and efficacy of cognitive behavioral therapy in treating people who are experiencing post-traumatic stress disorder after a heart attack.

Detailed Description

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PTSD usually develops in people who have experienced a traumatic or life-threatening event, including a health scare like a heart attack or catheterization. Symptoms of PTSD typically include anxiety, anger, and flashbacks or nightmares. PTSD symptoms are also associated with poor medical outcomes and nonadherence to medication after a heart attack. Fortunately, PTSD can sometimes be treated by antidepressants, anti-anxiety medication, and talk therapy. This study will compare the efficacy of cognitive-behavioral therapy (CBT) versus education and treatment as usual for treating people who are experiencing PTSD that is related to their cardiovascular illness (a heart attack or an invasive procedure such as catheterization).

Participants in this single-blind study will receive a psychiatric evaluation during which post-traumatic symptoms and feelings regarding their cardiovascular illness will be evaluated. Participants will then be randomly assigned to receive either CBT or a single educational session about PTSD, with up to 2 more follow-up educational meetings if needed. Participants assigned to the educational session will attend one meeting with a researcher to discuss the results from their evaluation. If they choose, they will also be referred to a mental health clinic for further care. Participants assigned to receive CBT will meet with a therapist once a week for at least 3 weeks. Participants will be offered the chance to meet with their therapist for two additional sessions if they need more time to discuss their symptoms. All participants will be re-evaluated at Months 2 and 6 using an interview, questionnaires,blood tests, blood pressure readings, and weight measurements.

Conditions

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Stress Disorders, Post-Traumatic

Keywords

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Myocardial Infarction (MI) Cognitive Behavioral Therapy (CBT) Adherence Depression

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Cognitive behavioral therapy (CBT)

Participants will receive cognitive behavioral therapy

Group Type EXPERIMENTAL

Cognitive behavioral therapy (CBT)

Intervention Type BEHAVIORAL

Participants meet with a therapist for three to five sessions brief exposure-based CBT.

Educational session and treatment as usual

Participants will receive an educational session and treatment as usual

Group Type ACTIVE_COMPARATOR

Educational session and treatment as usual

Intervention Type BEHAVIORAL

Participants assigned to the educational session attend one meeting with a researcher to discuss the results from their evaluation. They could also be referred to a mental health clinic of their choice to help relieve their symptoms.

Interventions

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Cognitive behavioral therapy (CBT)

Participants meet with a therapist for three to five sessions brief exposure-based CBT.

Intervention Type BEHAVIORAL

Educational session and treatment as usual

Participants assigned to the educational session attend one meeting with a researcher to discuss the results from their evaluation. They could also be referred to a mental health clinic of their choice to help relieve their symptoms.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Suffered an acute heart attack or invasive treatment procedure related to a cardiovascular illness within 2 to 12 months of study entry
* Meets the threshold PTSD screening criterion
* Prescribed an anticoagulant or anti-aggregant at least 2 weeks prior to study entry

Exclusion Criteria

* Readmitted to the hospital due to cardiovascular complications within 2 months of study entry
* Medically unstable
* Not prescribed aspirin
* Does not identify an event related to the cardiovascular illness as the primary trauma
* Cannot take care of self and is dependent on a caretaker for adherence to medications or clinic visits
* Suffers from other medical illnesses, including diseases that cause significant cognitive impairment (e.g., severe Alzheimer's), diseases that cause severe psychotic symptoms leading to disorientation (e.g., hepatic encephalopathy), diseases that cause brittle and uncontrollable blood pressure (e.g., pheochromocytoma), and diseases that cause uncontrollable hypercholesterolemia (e.g., severe familial hypercholesterolemia)
* Suicidal or history of suicide attempt
* Psychotic or suffers from a psychotic spectrum disorder
* Receiving psychotropic medications or psychotherapy and changed dosage or frequency of treatment within 2 weeks of study entry
* Currently receiving CBT
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

Icahn School of Medicine at Mount Sinai

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Eyal Shemesh, MD

Role: PRINCIPAL_INVESTIGATOR

Icahn School of Medicine at Mount Sinai

Locations

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Icahn School of Medicine at Mount Sinai

New York, New York, United States

Site Status

Elmhurst Hospital Center

Queens, New York, United States

Site Status

Countries

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United States

References

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Shemesh E, Annunziato RA, Weatherley BD, Cotter G, Feaganes JR, Santra M, Yehuda R, Rubinstein D. A randomized controlled trial of the safety and promise of cognitive-behavioral therapy using imaginal exposure in patients with posttraumatic stress disorder resulting from cardiovascular illness. J Clin Psychiatry. 2011 Feb;72(2):168-74. doi: 10.4088/JCP.09m05116blu. Epub 2010 Apr 6.

Reference Type RESULT
PMID: 20441725 (View on PubMed)

Other Identifiers

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R34MH071249

Identifier Type: NIH

Identifier Source: secondary_id

View Link

03-0985 DAHBR 96-BHC

Identifier Type: -

Identifier Source: secondary_id

GCO 03-0985

Identifier Type: -

Identifier Source: org_study_id