Attention Training Technique in Treatment of Anxiety and Depression in Coronary Heart Disease Patients

Anxiety and depression are associated with work disability, lower participation rate in cardiac rehabilitation and unfavourable life style changes following a coronary heart disease (CHD) event. The prevalence of clinically significant symptoms of depression and anxiety in CHD patients has been estimated to 30-50%. Furthermore, depression and anxiety are associated with a significant increased risk of subsequent major adverse cardiovascular events and mortality in CHD patients. Psychological interventions for anxiety and depression in CHD patients have demonstrated small and uncertain effects of symptoms, and no effect on cardiovascular outcomes. Therefore, testing the effectiveness of specific psychological interventions that may affect central mechanisms for cardiovascular outcomes, has been requested. The Attention training (ATT) Study is a randomized controlled trial comparing group-attention training to wait-list control in 64 patients who experience significant anxiety and depression after a CHD event. It will also be explored whether reduction in psychological symptoms is correlated with changes in biological markers with a potential link to cardiovascular outcomes.

Inclusion Criteria:Established coronary heart disease as main somatic disease>=8 on either HADS-anxiety or depression subscaleAge 18 - 65 yearsThe ability to understand and speak Norwegian language,Willingness and ability to give informed consent.Exclusion Criteria:Current or past neurological illnessTraumatic brain injuryCurrent alcohol and/or substance dependency disordersPsychotic disordersBipolar disordersDevelopmental disordersMental retardationCognitive impairment which precludes informed consent/ability to participateAcute suicidalityLife-expectancy less than 12 monthsConcurrent psychological intervention for emotional distressAntidepressant or anxiolytic medication initiated during previous 8 weeks