Helena Grönqvist*, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden Erik Olsson, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden Fredrika Norlund, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden Emma Wallin, Department of Psychology, Uppsala University, Uppsala, Sweden Gunilla Burell, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden Timo Hursti, Department of Psychology, Uppsala University, Uppsala, Sweden Louise von Essen*, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden Claes Held, Uppsala Clinical Research center, Uppsala University, Uppsala, Sweden Track: Research Presentation Topic: Public (e-)health, population health technologies, surveillance Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2013-09-25

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Louise von Essen and Claes Held
Background: Depressive disorders are present in at least 30% of patients after myocardial infarction (MI) and are associated with adverse cardiovascular outcomes, even after controlling for other risk factors. In addition, depression is a chronic, disabling condition associated with poor quality of life, functional limitations, less favorable self-care behaviors, and higher health care costs. A behavioral model for the development of depression after MI can be applied where normally stimulating and naturally reinforcing behaviors like occupational work, physical activity and intimate relationships may change due to the disease and may lead to the development of depression that remains more than a year after MI. U-CARE is one of the Swedish government’s strategic research programs at Uppsala University. Its overarching goal is to promote psychosocial health among patients suffering from somatic disease and their significant others, hopefully at a reduced cost for individuals and the society. It is suggested that the personal and societal costs can be significantly reduced by a timely offer of support via the internet.
Objective: The overall aim is to evaluate the effects of an Internet-based CBT-program on level of depression and anxiety in patients with such symptoms after MI. This presentation will report on a protocol for the study.
Methods: Five hundred patients younger than 75 years with symptoms of anxiety and/or depression after MI will be randomized either to 14 weeks of internet-based CBT or to usual care which is the control condition. Primary outcomes are level of anxiety and depression measured directly after treatment with the Hospital Anxiety and Depression Scale, the Montgomery-Ã…sbergs Depression Rating Scale and the Cardiac Anxiety Questionnaire. Follow-up measures will be collected ten months after end of treatment.
Results: Patient recruitment will start spring 2013 and will continue for approximately two years.
Conclusion: This study will test a new treatment concept and answer a crucial management question for patients with depressive and anxious symptoms post MI. It may influence future clinical practice if the treatment results are positive.