Metacognitive Short-Term Intervention in Patients With Mental Disorders Following Cardiovascular Events

Abstract

BackgroundMental disorders are common among patients with severe cardiovascular diseases (CVD). Yet, there is a lack of easily accessible evidence-based treatments. Recent research indicates elevated prevalence of dysfunctional metacognitions in patients with mental disorders following cardiovascular events. As metacognitive therapy (MCT) is an established treatment to modify metacognitions, we tested if a brief metacognitive intervention via videotelephony is effective in this patient group.MethodsA brief MCT treatment was tailored to CVD patients and designed as a face-to-face internet-based intervention. Five patients with CVDs and comorbid mental disorders underwent a psychocardiological examination and diagnostic approach. Each patient participated in eight 50 min sessions via encrypted video messenger service. Metacognitions, depression and anxiety symptoms and quality of life were assessed by self-report measures pre- and post-treatment. Patients rated dysfunctional thought processes, current psychological impairment, and treatment satisfaction after each session. Intended follow-up measures were not reported due to missing data.ResultsFor most patients, the brief metacognitive intervention was associated with a decrease in dysfunctional metacognitions and a reduction of symptoms of anxiety and depression post-treatment. Psychological and physiological quality of life improved. Patients reported high satisfaction with the tailored treatment.ConclusionOur results suggest that a brief internet-based metacognitive treatment may be a promising tool for patients with CVDs and comorbid mental disorders. Feasibility and acceptance of the intervention was rated high by the patients. Further research is necessary to support the preliminary findings and to adapt and evaluate the intervention in a controlled clinical trial setting.

Improving mental well-being in psychocardiology—a feasibility trial for a non-blended web application as a brief metacognitive-based intervention in cardiovascular disease patients

“…These were designed to teach strategies for dealing with worry and rumination according to metacognitive therapy. The results of this study suggest that patients may benefit in terms of symptom reductions and an increase in metacognitive competence in themselves following these eight online video sessions ( 27 ).…”

“…Here, we developed an MCT-based brief intervention as a web app with learning content based on results of the former developed and tested face-to-face trial ( 27 ). We translated the individually tailored modular learning content into digital form, which includes video recording, creating animations and recording the audio content.…”

“…The web app is based on preliminary work by our research group, in which the German version of metacognitive therapy (MCT) manual ( 12 ) was used to create a brief intervention for patients with CVDs ( 27 ). The web app can be used by patients across different platforms and devices, e.g., a smartphone, tablet, or computer.…”

“…It consists of two main parts, learning and practicing. Following the brief instructions in the email, a patient enters the learning section, which consists of six modules based on the described short-term MCT intervention ( 27 ). Each module includes five to eight psychoeducational videos in which an animated character guides participants through the training program.…”

“…In this context, some studies have provided promising data, showing, that brief psychological interventions can help patients with CVDs get back into everyday activity ( 25 ). Recently, MCT has been also shown to be an encouraging approach for brief internet interventions ( 26 , 27 ). In a recent case series from our own lab, patients with CVD and psychological distress underwent eight adapted video call sessions with a psychotherapist of 50 min each.…”