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Enhancing Recovery in Coronary Heart Disease (ENRICHD) study intervention: rationale and design.

2001; National Institutes of Health; Volume: 63; Issue: 5 Linguagem: Inglês

Lisa Berkman, A.A. Jaffe, Robert M. Carney, Susan M. Czajkowski, Philip A. Kaufman, James A. Blumenthal, P. Arias, Michael A. Babyak, Teri T. Baldewicz, John C. Barefoot, Johan Bennett, Robert A. Carels, Ben Crenshaw, Siân Curtis, Leslie L. Davis, Karl R. Fath, Leslie Forman, Afton L. Hassett, Srishti Hegde, Steven H. Herman, Alan L. Hinderliter, Parinda Khatri, William E. Kraus, Ranga Krishnan, Shoshana Levenberg, Daniel B. Mark, P März, Robert J. McCarthy, Gary Miller, Jennifer Norten, Christopher O’Connor, Joseph Puma, L. Rutt, Wendy Sessions, IC Siegler, L. Watkins, Robert Waugh, Rachel E. Williams, Amy E. Wilson, Bosh Zakhary, Lynda H. Powell, J. E. Calvin, David C. Clark, Suzannah K. Creech, Danielle Symons Downs, Claudia Eaton, W.J. Elliott, Lamyaa M. Kassem, A. Luten, Carlos F. Mendes de Leon, William S. Miles, R. Munoz-Dunbar, Paige Pfenninger, Carol Rogers Pitula, S. Szeplakay, John Zajecka, Janet Zander, Robert F. DeBusk, L. Balenesi, Aldo R. Casteneda, Allison Deeter, Susan D. Duenke, L. F. Forseth, Erika Sivarajan Froelicher, Remonda Hanna, H Kaiser, Sarah E Lamb, Shivanshu Madan, Margaret Marnell, Nancy Houston Miller, K Parker, Diane Strachowski, C. Barr Taylor, Carl E. Thoresen, James M. Raczynski, Benjamin Adams, Sybil Allison, M Bandy, Julian C. Barton, Lauren Bates, Vera Bittner, Mark A. Cole, Carol E. Cornell, Vicki DiLillo, Jeffrey J. Dolce, Jaime Gilliland, Sheryl G. Jordan, Jerome H. Markovitz, David P. Mason, John L. Shuster, Peter White, Suzan Winders, N. Schneiderman, Marc D. Gellman, Gail Ironson, Kristin Kilbourn, M. E. Manrique-Reichard, Judith R. McCalla, Thomas A. Mellman,

Cardiac Health and Mental Health

Depression and low social support are risk factors for medical morbidity and mortality after acute MI. The ENRICHD study is a multicenter, randomized, controlled clinical trial of a cognitive-behavioral treatment for depression and low social support in post-MI patients. A total of 2481 patients were recruited (26% with low social support, 39% with depression, and 34% with low social support and depression). Our objective is to describe the rationale, design, and delivery of the ENRICHD intervention.Key features of the intervention include the integration of cognitive-behavioral and social learning approaches to the treatment of depression and a diverse set of problems that can contribute to low social support; rapid initiation of treatment after MI; a combination of individual and group modalities; adjunctive pharmacotherapy for severe or intractable depression; training, certification, and supervision of therapists; and quality assurance procedures.The trial's psychosocial and medical outcomes will be presented in future reports.The ENRICHD protocol targets two complex psychosocial risk factors with a multifaceted intervention, which is delivered in an individualized manner to accommodate a demographically, medically, and psychiatrically diverse patient population. Additional research will be needed to identify optimal matches between patient characteristics and specific components of the intervention.