Please select the eligibility criteria that correspond to the clinical trial below.
Title: Well-Being Therapy for Psychological Distress and Enhancing Healthy Behaviors With Personalized Mobile Technology in Cardiac Patients: a Randomized Controlled-trial Study Protocol
Brief Summary: The WELL-ME study is a three-arm randomized controlled clinical trial (RCT). The aim of this RCT is to compare the effectiveness of the Well Being Web Based Therapy (WBT-Web) with the gold standard CBT (Cognitive Behavior Therapy) and standard clinical procedure of patients' management (CM) for psychological distress and promotion of healthy behaviors in Cardiac Patients.


Options:
A: Inclusion Criteria:

* Coronary Artery Bypass Graft (CABG) surgery (alone or combined with valvular or carotid surgery) within past 12 months
* Meets DSM-IV criteria for major or minor depressive episode

Exclusion Criteria:

* Severe cognitive impairment
* Severe psychiatric comorbidity (e.g., alcoholism or schizophrenia)
* Severely debilitating or life-threatening illness other than coronary disease
B: Inclusion Criteria:

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

Exclusion Criteria:

* uncertain prognosis for 12 months due to other conditions
* acute coronary disease in recent months.
* existence of another life-threatening illness of the patient (such as active cancer, chronic kidney failure).
* severe neurological problem (Brain syndrome / orientation problem/ difficult peripheral neuropathy).
* severe mental illness (active psychosis / suicide risk / severe dementia).
* linguistic limitations (such as stuttering / untreated audio impairment).
* a significant functional problem (such as unconsciousness / connection to respiration device / confined to a wheelchair or bed / severe walking disability / needs help with complete basic daily activities).
* objective limit that endangers liability for participation in the seven meetings (such as remote residential / tourist / convict / drug addict).
C: Inclusion Criteria:

* Language (speaks and understands English)
* Between 45-80 years old
* Stable coronary artery disease (based on no hospitalization for cardiac events for at least 7 weeks prior)
* Angiographic documentation of presence and extent of coronary artery disease (number of vessels involved, extent of stenosis, etc.)
* Written, informed consent

Exclusion Criteria:

* Significant acute medical illness (sepsis, autoimmune condition, drug overdose, uncontrolled diabetes, severely disturbed liver, kidney or lung function, anemia, hypothyroidism)
* Clinically significant cognitive impairment (Mini-Mental State Examination \< 24)
* Other neurologic conditions (Parkinson's disease, Huntington's chorea, history of epilepsy, birth trauma, significant traumatic brain injury, clinical stroke, progressive supranuclear paralysis, brain tumour, subdural hematoma, multiple sclerosis)
* Canadian Cardiovascular Society Class 4 (indicating unstable angina)
* Ventricular tachycardia and/or implantable cardioverter defibrillator
* Killip class greater than II (indicates high risk of mortality in post-myocardial infarction group)
* Premorbid or concurrent psychiatric diagnoses of schizophreniform or bipolar depressive disorders, current ethanol or substance abuse or any premorbid psychiatric condition requiring hospitalization
* Current use of a concentrated omega-3 fatty acid supplement, or contraindication to soybean/corn oil
* Pregnant women
* Women who become pregnant during the course of the study will be excluded immediately.
* Women of childbearing potential must be using an approved method of birth control.
* Allergies or hypersensitivity to fish
* Pre-existing bleeding disorder
* History of electroconvulsive therapy.
* Suicidal ideation or a history of suicidal ideation/attempts (determined during SCID-I at screening/baseline visits)
* Severe depression, defined by Hamilton Depression Rating score \>23
* Current or history of psychotic episode or personality disorder.
D: Inclusion Criteria:

1. Hospitalization with a verified diagnosis of unstable angina (UA) or acute myocardial infarction (AMI). UA is defined as new-onset angina within 2 months, exacerbation of previous angina with pain at rest or with minimal exercise, prolonged chest pain (lasting \> 20 minutes), or angina within 2 weeks following discharge for myocardial infarction in patients with documented coronary artery disease (defined as ischemic ECG ST-T segment changes, previously documented MI, positive nuclear treadmill test result, or coronary angiographic evidence of blockage of 50% stenosis in \>1 major coronary artery). AMI is defined as at least 2 of the following: ischemic chest pain lasting \>20 minutes, acute rise in serum troponin-I \>1.0 ng/L, and new pathologic ST segments in \>2 contiguous ECG leads.
2. Score on the Beck Depression Inventory (BDI) \> 10 within 7 days of index ACS event and 3-months later.

Exclusion Criteria:

1. active suicidal or homicidal ideation, as these patients require immediate referral for assessment and treatment (see below for procedures for these patients);
2. current alcohol or other substance abuse disorders (as depressive symptoms may be a result of these disorders),
3. any current psychotic disorder,
4. history of psychotic disorder, bipolar disorder, or serious personality disorders,
5. diagnosis of a terminal non-cardiac illness,
6. ACS diagnosis secondary to diagnosis of a severe medical disease,
7. inability to communicate in English,
8. levels of cognitive impairment indicative of dementia,
9. unavailability for the period of the study,
10. overt hypothyroid, and
11. currently taking triptans.

Answer: B