Please select the eligibility criteria that correspond to the clinical trial below.
Title: Cognitive-behavioral Treatment of Depression in Patients With Acute Coronary Syndrome
Brief Summary: Emotional states of depression in association with ischemic heart diseases, such as myocardial infarction or unstable angina, are risk factors for subsequent cardiac events and mortality. However, the only psychological intervention trial attempting to reduce cardiac risk in depressed ACS patients showed that changes in depression did not translate into improved survival. Such intervention did not address issues such as lifestyle modification and improvement in psychological well-being, which were found to affect individual vulnerability to medical disease. Our research group has developed a well-being enhancing psychotherapeutic strategy, well-being therapy (WBT), which has been validated in a number of clinical trials. The aim of this project is to evaluate the efficacy of cognitive behavioral treatment (CBT) together with lifestyle modification and WBT in reducing cardiac risk in depressed and/or demoralized ACS patients compared to a standard clinical procedure of patients' management, the clinical management (CM). The same protocol will be carried out in two centres (Bologna and Torino). 100 patients after a first episode of myocardial infarction or unstable angina, meeting DSM-IV criteria for depressive disorders and DCPR criteria for demoralization will be randomized to one of two treatment groups: 1) CBT supplemented by lifestyle modification and WBT; 2) CM. In both groups, treatment will consist of twelve, 45-minute sessions once a week. A two-year follow-up will be performed. It is expected that psychological treatment may significantly decrease cardiac morbidity and mortality at follow-up compared to clinical management. The findings may entail considerable preventive implications and possible large reductions in health costs.


Options:
A: Inclusion Criteria:

* at least moderate depressive symptoms (PHQ-9 ≥ 10)
* rural dwelling
* has had physician-documented acute coronary syndrome (ACS) event

Exclusion Criteria:

* cognitive impairment
* major psychiatric comorbidities, which might require additional treatment
* presence of non-CHD conditions likely to be fatal within next year.
B: 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.
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:

* 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

Answer: D