Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Collaborative Care Program to Improve Depression Treatment in Cardiac Patients
Brief Summary: Depression in cardiac patients is common, persistent, and deadly. However, the vast majority of cardiac patients with depression go unrecognized and untreated, despite the existence of treatments that clearly improve depressive symptoms and may favorably impact survival. Our research group and others have found that depression recognition and treatment appears particularly limited among patients with acute cardiac illness, though this population may be the most vulnerable to the deleterious effects of depression. We propose a project, building on successful collaborative care depression management programs in outpatient settings, to address this important issue.

The specific hypotheses behind the proposed research are that a collaborative care depression management program can be successfully adapted to inpatient cardiac units, and that such a program will lead to greater rates of adequate depression treatment and improvements in secondary outcomes.

The following specific aims capture the stepwise goals of this program:

1. To determine whether a collaborative care depression management program ('Enhanced Care') leads to significantly increased rates of adequate depression treatment compared to usual care (screening and feedback) (Primary Aim).
2. To assess whether this Enhanced Care program has a lasting impact on adequate depression treatment, depressive symptoms, health-related quality of life, and adherence to medical recommendations at 6 weeks, 12 weeks, and 6 months, compared to usual care.


Options:
A: Inclusion Criteria:

* a current diagnosis of at least one of the following: major or minor depression, dysthymia according to DSM-IV criteria, and demoralization according to DCPR criteria
* Mini-Mental State Examination score higher than 24
* written informed consent provided by the patient to participate

Exclusion Criteria:

* history of bipolar disorder (DSM-IV criteria)
* major depression with psychotic features
* history of substance abuse or dependency during the previous 12 months
* serious suicide risk
* current use of antidepressants
* current treatment with any form of psychotherapy
B: Inclusion Criteria:

* Inpatient admission for cardiac diagnosis
* Positive depression evaluation (PHQ-2\>2, PHQ-9\>9)
* Ability to provide informed consent

Exclusion Criteria:

* Active suicidal ideation
* Bipolar disorder, psychotic disorder, active substance use disorder
C: Inclusion Criteria:

* The inclusion criteria were to be a dyad consisting of a patient diagnosed with heart failure based on the European Society of Cardiology guidelines,
* New York Heart Association (NYHA) class II-IV,
* with a partner living in the same household as the patient,
* recently discharged from hospital (i.e. 2-3 weeks) following a heart failure acute exacerbation.

Exclusion Criteria:

* Exclusion criteria for the dyads were dementia, or other severe psychiatric illnesses,
* drug abuse,
* difficulties in understanding or reading the Swedish language,
* undergoing cardiac surgery including cardiac transplant or
* participating in other studies.
D: Inclusion Criteria:

Prospective Cohort

* Written informed consent
* Age 18 years and older
* New diagnosis of non-valvular atrial fibrillation (diagnosed within the last 6 weeks) with at least one additional risk factor for stroke and regardless of therapy.

Retrospective validation cohort

* Written informed consent
* Age 18 years and older
* Diagnosis of non-valvular AF (diagnosed 6-24 months prior to enrolment) with at least one additional risk factor for stroke and regardless of therapy.

Exclusion criteria:

* No further follow-up envisaged or possible within enrolling hospital or with associated family practitioner.
* Patients with transient AF secondary to a reversible cause.
* Patients recruited in controlled clinical trials.

Answer: B