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Regular Article

Psychological and Quality-of-Life Outcomes from a Comprehensive Stress Reduction and Lifestyle Program in Patients with Coronary Artery Disease: Results of a Randomized Trial

Michalsen A.a · Grossman P.b · Lehmann N.c · Knoblauch N.T.M.a · Paul A.a · Moebus S.c · Budde T.d · Dobos G.J.a

Author affiliations

aKliniken Essen-Mitte, Chair of Complementary and Integrative Medicine of the University Duisburg-Essen, Department of Internal Medicine V and Integrative Medicine, Essen, Germany; bUniversity Hospital Basel, Department of Psychosomatic & Internal Medicine, Basel, Switzerland; cUniversity of Duisburg-Essen, Institute for Medical Informatics, Biometry and Epidemiology, and dAlfried Krupp Krankenhaus, Department of Cardiology, Essen, Germany

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Psychother Psychosom 2005;74:344–352

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Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: October 19, 2005
Issue release date: October 2005

Number of Print Pages: 9
Number of Figures: 1
Number of Tables: 5

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS

Abstract

Background: Stress reduction and comprehensive lifestyle modification programs have improved atherosclerosis and cardiac risk factors in earlier trials. Little is known about the impact of such programs on quality-of-life (QoL) and psychological outcomes. Given recent significant improvements in cardiac care, we evaluated the current benefit of stress reduction/lifestyle modification on QoL and emotional distress in patients with coronary artery disease (CAD). Methods: 101 patients (59.4 ± 8.6 years, 23 female) with CAD were randomized to a 1-year lifestyle/stress management program (n = 48) or written advice (n = 53). QoL and psychological outcomes were assessed with the SF-36, Beck Depression, Spielberger State/Trait Anxiety, Spielberger State/Trait Anger and Perceived Stress Inventories. Group repeated-measures analyses of variance were performed for all measures. Results: Adherence to the program was excellent (daily relaxation practice 39 ± 5vs. 5 ± 8 min, respectively; p < 0.001). Both groups improved comparably in most dimensions of QoL, and significantly greater improvements for the lifestyle group were found for physical function and physical sum score (p = 0.046 and p = 0.045). Depression, anxiety, anger and perceived stress were reduced similarly in both groups. However, intervention × gender interaction effects revealed greater benefits among women in the lifestyle intervention vs. advice group for depression and anger (p = 0.025 and p = 0.040), but no effects for men. Conclusions: A comprehensive lifestyle modification and stress management program did not improve psychological outcomes in medically stable CAD patients. The program did appear to confer psychological benefits for women but not men. Further trials should investigate gender-related differences in coronary patient responses to behavioral interventions.

© 2005 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: October 19, 2005
Issue release date: October 2005

Number of Print Pages: 9
Number of Figures: 1
Number of Tables: 5

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS


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