DepressionSPIRR-CADNCT00705965
Effects of a Psychotherapy Intervention in Depressed Patients With Coronary Artery Disease
A study testing Psychotherapy, Information session and Usual cardiological care in people with Depression and Coronary Artery Disease, run by University of Göttingen at 10 sites in Germany.
Trial summary
In patients with coronary artery disease (CAD), depressive symptoms are frequent and highly relevant for quality of life, health behaviour, health care costs, and prognosis. The aim of the current study is to evaluate the effects of a psychotherapy intervention on symptoms of depression in patients with CAD. Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Depression, Coronary Artery Disease
- What is being tested?
- Psychotherapy, Information session and Usual cardiological care
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 570 participants
- Where
- 10 sitesGermany
- Study dates
- Nov 2008to Apr 2013
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients with coronary artery disease
- German speaking men and women
- Recent coronary angiogram (<= 3 months old)
- Depression score (HADS-D) >= 8
- Written informed consent
Who cannot join
- Severe heart failure
- Other acutely life- threatening conditions
- Severe chronic inflammatory disease
- Current suicidal tendency
- Severe depressive episode
- Other severe mental illness.
Trial locations and contacts
10 sites in 1 country.
10 sites in 1 country
Germany10 sites
Berlin University Medical Center, Campus Benjamin Franklin, Dept. of Psychosomatics and Psychotherapy
Berlin, D-12200
University of Cologne, Dept. Psychosomatics and Psychotherapy
Cologne, D-50931
Technical University of Dresden, Dept. of Psychotherapy and Psychosomatics
Dresden, D-01307
University Hospital of Freiburg, Dept. of Psychosomatic Medicine and Psychotherapy
Freiburg im Breisgau, D-79104
University of Goettingen, Dept. of Psychosomatic Medicine and Psychotherapy
Göttingen, D-37075
Hannover Medical School, Dept. of Psychosomatics and Psychotherapy
Hanover, D-30625
University of Heidelberg, Dept. of General Internal and Psychosomatic Medicine
Heidelberg, D-69120
University Hospital of Mainz, Dept. of Psychosomatic Medicine and Psychotherapy
Mainz, D-55131
Technical University of Munich, Institute and Dept. of Psychosomatic Medicine, Psychotherapy and Medical Psychology
München, D- 81675
Nuremberg General Hospital, Department of Psychosomatic Medicine and Psychotherapy
Nuremberg, D-90419
About this study
Official title: A Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease - a Randomised Controlled Trial (SPIRR-CAD)
In patients with coronary artery disease (CAD), depressive symptoms are frequent and highly relevant for quality of life, health behaviour, health care costs, and prognosis. The aim of the current study is to evaluate the effects of a psychotherapy intervention on symptoms of depression in patients with CAD. Therefore, depressed patients diagnosed with CAD will be randomised into a controlled intervention trial, comparing a stepwise psychotherapy intervention with usual cardiological care. The manualized psychotherapy intervention starts with three individual sessions offered on a weekly basis. Afterwards, symptoms of depression will be re-evaluated and, in case of persisting symptoms, patients receive an additional 25 sessions of psychodynamic group psychotherapy over a total period of one year. The psychodynamic approach was chosen in order to specifically take into account personality traits such as negative affectivity and social inhibition, the components of the Type D personality, which may explain why recent cognitive behavioural psychotherapy (CBT) trials produced only small effects in depressed CAD patients. The investigators expect that the intervention will reduce depressive symptoms as well as the prevalence of depressive disorders. It will also improve both behaviourally and physiologically mediated cardiovascular risk indicators, promote better quality of life, and reduce healthcare costs. Subgroup analyses will be performed in order to identify gender-specific treatment effects, effects on immunological stress reactivity, and genetic predictors of treatment success.
- Conditions
- Depression, Coronary Artery Disease
- Being tested
- Psychotherapy, Information session, Usual cardiological care
- Keywords
- Coronary artery disease, depression, psychotherapy, randomized controlled trial
- Medical subject headings
- Depression, Coronary Artery Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PsychotherapyBehavioural
Also called Stepwise manualized psychotherapy
Stepwise, manualized individual and group psychotherapy in addition to usual cardiological care.
Information sessionBehavioural
One information session about living with heart disease.
Usual cardiological careOther
Usual cardiological care
| Study group | Role | What they receive |
|---|---|---|
| 1 | Experimental | Stepwise, manualized individual and group psychotherapy in addition to usual cardiological care. Receives: Behavioral: Psychotherapy; Other: Usual cardiological care |
| 2 | Active comparator | Usual cardiological care including one information session. Receives: Behavioral: Information session; Other: Usual cardiological care |
What is being measured
The primary outcome is the main question the study is designed to answer.
Changes from baseline to 18 months in depressive symptoms (HADS-D)
Measured: 18 months
Secondary outcomes (8)
Remission of depressive disorder (SCID) and the Type D pattern (DS-14), reduced severity of depressive symptoms (HAM-D)
Measured: 18 months
Health-related quality of life (SF36, EuroQuol-5D)
Measured: 18 months
cardiovascular risk profile
Measured: 18 months
neuroendocrine and immunological activation
Measured: 18 months
coagulation
Measured: 18 months
heart rate variability
Measured: 18 months
cardiac events
Measured: 18 months
health care utilisation and costs
Measured: 18 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jun 2008 (estimated)
- Study startNov 2008
- Primary completionApr 2013
- Study completionApr 2013
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for DepressionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 570 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Göttingen
- Sponsor type
- University, hospital or other
- Collaborators
- University of Cologne, Johannes Gutenberg University Mainz, Humboldt-Universität zu Berlin, University Hospital Freiburg, Kerckhoff Rehabilitation Center Bad Nauheim, Heidelberg University, Hannover Medical School, Technical University of Munich, Technische Universität Dresden, Nuremberg General Hospital, The Clinical Trials Centre Cologne, German Research Foundation, Medical University of Graz
- Responsible party
- Principal investigator, Christoph Herrmann-Lingen, University of Göttingen
- Investigators
- Christoph Herrmann-Lingen, MD, Principal investigator, University of Goettingen, Dept. of Psychosomatic Medicine and PsychotherapyChristian Albus, MD, Principal investigator, University of Cologne, Dept. of Psychosomatics and Psychotherapy
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00705965
- Sponsor's protocol ID
- ZKSK-371
- Acronym
- SPIRR-CAD
- Status last verified
- Aug 2016
- First submitted
- 25 Jun 2008
- Last updated
- 30 Aug 2016
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Albus C, Beutel ME, Deter HC, Fritzsche K, Hellmich M, Jordan J, Juenger J, Krauth C, Ladwig KH, Michal M, Mueck-Weymann M, Petrowski K, Pieske B, Ronel J, Soellner W, Waller C, Weber C, Herrmann-Lingen C. A stepwise psychotherapy intervention for reducing risk in coronary artery disease (SPIRR-CAD) - rationale and design of a multicenter, randomized trial in depressed patients with CAD. J Psychosom Res. 2011 Oct;71(4):215-22. doi: 10.1016/j.jpsychores.2011.02.013. Epub 2011 Apr 15.
PubMed 21911098Herrmann-Lingen C, Beutel ME, Bosbach A, Deter HC, Fritzsche K, Hellmich M, Jordan J, Junger J, Ladwig KH, Michal M, Petrowski K, Pieske B, Ronel J, Sollner W, Stohr A, Weber C, de Zwaan M, Albus C; SPIRR-CAD Study Group. A Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease (SPIRR-CAD): Results of an Observer-Blinded, Multicenter, Randomized Trial in Depressed Patients With Coronary Artery Disease. Psychosom Med. 2016 Jul-Aug;78(6):704-15. doi: 10.1097/PSY.0000000000000332.
PubMed 27187851Fangauf SV, Meyer T, Albus C, Binder L, Deter HC, Ladwig KH, Michal M, Ronel J, Rothenberger A, Sollner W, Wachter R, Weber CS, Herrmann-Lingen C; SPIRR-CAD group. Longitudinal relationship between B-type natriuretic peptide and anxiety in coronary heart disease patients with depression. J Psychosom Res. 2019 Aug;123:109728. doi: 10.1016/j.jpsychores.2019.05.006. Epub 2019 May 21.
PubMed 31376874Vitinius F, Escherich S, Deter HC, Hellmich M, Junger J, Petrowski K, Ladwig KH, Lambertus F, Michal M, Weber C, de Zwaan M, Herrmann-Lingen C, Ronel J, Albus C. Somatic and sociodemographic predictors of depression outcome among depressed patients with coronary artery disease - a secondary analysis of the SPIRR-CAD study. BMC Psychiatry. 2019 Feb 4;19(1):57. doi: 10.1186/s12888-019-2026-6.
PubMed 30717711Sollner W, Muller MM, Albus C, Behnisch R, Beutel ME, de Zwaan M, Fritzsche K, Habermeier A, Hellmich M, Jordan J, Junger J, Ladwig KH, Michal M, Petrowski K, Ronel J, Stein B, Weber C, Weber R, Herrmann-Lingen C. The relationship between attachment orientations and the course of depression in coronary artery disease patients: A secondary analysis of the SPIRR-CAD trial. J Psychosom Res. 2018 May;108:39-46. doi: 10.1016/j.jpsychores.2018.02.014. Epub 2018 Feb 24.
PubMed 29602324Orth-Gomer K, Deter HC, Grun AS, Herrmann-Lingen C, Albus C, Bosbach A, Ladwig KH, Ronel J, Sollner W, de Zwaan M, Petrowski K, Weber C; SPIRR-CAD Study Group. Socioeconomic factors in coronary artery disease - Results from the SPIRR-CAD study. J Psychosom Res. 2018 Feb;105:125-131. doi: 10.1016/j.jpsychores.2017.12.005. Epub 2017 Dec 5.
PubMed 29332628Lambertus F, Herrmann-Lingen C, Fritzsche K, Hamacher S, Hellmich M, Junger J, Ladwig KH, Michal M, Ronel J, Schultz JH, Vitinius F, Weber C, Albus C. Prevalence of mental disorders among depressed coronary patients with and without Type D personality. Results of the multi-center SPIRR-CAD trial. Gen Hosp Psychiatry. 2018 Jan-Feb;50:69-75. doi: 10.1016/j.genhosppsych.2017.10.001. Epub 2017 Oct 7.
PubMed 29078170
Study at a glance
From the registry record, last updated by the sponsor on 30 Aug 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease - a Randomised Controlled Trial (SPIRR-CAD)
- ClinicalTrials.gov ID
- NCT00705965
- Acronym / sponsor ID
- SPIRR-CAD / ZKSK-371
- Conditions
- Depression, Coronary Artery Disease
- Keywords
- Coronary artery disease, depression, psychotherapy, randomized controlled trial
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 570 participants (actual)
- Lead sponsor
- University of GöttingenUniversity, hospital or other
- Collaborators
- University of Cologne, Johannes Gutenberg University Mainz, Humboldt-Universität zu Berlin, University Hospital Freiburg, Kerckhoff Rehabilitation Center Bad Nauheim, Heidelberg University, Hannover Medical School, Technical University of Munich, Technische Universität Dresden, Nuremberg General Hospital, The Clinical Trials Centre Cologne, German Research Foundation, Medical University of Graz
- Study start
- Nov 2008
- Primary completion
- Apr 2013 (actual)
- Study completion
- Apr 2013 (actual)
- First posted
- 27 Jun 2008 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
In patients with coronary artery disease (CAD), depressive symptoms are frequent and highly relevant for quality of life, health behaviour, health care costs, and prognosis. The aim of the current study is to evaluate the effects of a psychotherapy intervention on symptoms of depression in patients with CAD. Therefore, depressed patients diagnosed with CAD will be randomised into a controlled intervention trial, comparing a stepwise psychotherapy intervention with usual cardiological care. The manualized psychotherapy intervention starts with three individual sessions offered on a weekly basis. Afterwards, symptoms of depression will be re-evaluated and, in case of persisting symptoms, patients receive an additional 25 sessions of psychodynamic group psychotherapy over a total period of one year. The psychodynamic approach was chosen in order to specifically take into account personality traits such as negative affectivity and social inhibition, the components of the Type D personality, which may explain why recent cognitive behavioural psychotherapy (CBT) trials produced only small effects in depressed CAD patients. The investigators expect that the intervention will reduce depressive symptoms as well as the prevalence of depressive disorders. It will also improve both behaviourally and physiologically mediated cardiovascular risk indicators, promote better quality of life, and reduce healthcare costs. Subgroup analyses will be performed in order to identify gender-specific treatment effects, effects on immunological stress reactivity, and genetic predictors of treatment success.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| 1 | Experimental | Behavioral: Psychotherapy, Other: Usual cardiological careStepwise, manualized individual and group psychotherapy in addition to usual cardiological care. |
| 2 | Active comparator | Behavioral: Information session, Other: Usual cardiological careUsual cardiological care including one information session. |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Patients with coronary artery disease
- German speaking men and women
- Recent coronary angiogram (<= 3 months old)
- Depression score (HADS-D) >= 8
- Written informed consent
Key exclusion criteria (6 listed)
- Severe heart failure
- Other acutely life- threatening conditions
- Severe chronic inflammatory disease
- Current suicidal tendency
- Severe depressive episode
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PsychotherapyAlso: Stepwise manualized psychotherapyStepwise, manualized individual and group psychotherapy in addition to usual cardiological care. | Behavioural | 1 |
| Information sessionOne information session about living with heart disease. | Behavioural | 2 |
| Usual cardiological careUsual cardiological care | Other | 1, 2 |
Primary outcome
Changes from baseline to 18 months in depressive symptoms (HADS-D)
Time frame: 18 months
8 secondary outcomes
Remission of depressive disorder (SCID) and the Type D pattern (DS-14), reduced severity of depressive symptoms (HAM-D)
Time frame: 18 months
Health-related quality of life (SF36, EuroQuol-5D)
Time frame: 18 months
cardiovascular risk profile
Time frame: 18 months
neuroendocrine and immunological activation
Time frame: 18 months
coagulation
Time frame: 18 months
heart rate variability
Time frame: 18 months
cardiac events
Time frame: 18 months
health care utilisation and costs
Time frame: 18 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Aug 2016.
- Background: PubMed 21911098Albus C, Beutel ME, Deter HC, Fritzsche K, Hellmich M, Jordan J, Juenger J, Krauth C, Ladwig KH, Michal M, Mueck-Weymann M, Petrowski K, Pieske B, Ronel J, Soellner W, Waller C, Weber C, Herrmann-Lingen C. A stepwise psychotherapy intervention for reducing risk in coronary artery disease (SPIRR-CAD) - rationale and design of a multicenter, randomized trial in depressed patients with CAD. J Psychosom Res. 2011 Oct;71(4):215-22. doi: 10.1016/j.jpsychores.2011.02.013. Epub 2011 Apr 15.
- Results publication: PubMed 27187851Herrmann-Lingen C, Beutel ME, Bosbach A, Deter HC, Fritzsche K, Hellmich M, Jordan J, Junger J, Ladwig KH, Michal M, Petrowski K, Pieske B, Ronel J, Sollner W, Stohr A, Weber C, de Zwaan M, Albus C; SPIRR-CAD Study Group. A Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease (SPIRR-CAD): Results of an Observer-Blinded, Multicenter, Randomized Trial in Depressed Patients With Coronary Artery Disease. Psychosom Med. 2016 Jul-Aug;78(6):704-15. doi: 10.1097/PSY.0000000000000332.
- Derived from this study: PubMed 31376874Fangauf SV, Meyer T, Albus C, Binder L, Deter HC, Ladwig KH, Michal M, Ronel J, Rothenberger A, Sollner W, Wachter R, Weber CS, Herrmann-Lingen C; SPIRR-CAD group. Longitudinal relationship between B-type natriuretic peptide and anxiety in coronary heart disease patients with depression. J Psychosom Res. 2019 Aug;123:109728. doi: 10.1016/j.jpsychores.2019.05.006. Epub 2019 May 21.
- Derived from this study: PubMed 30717711Vitinius F, Escherich S, Deter HC, Hellmich M, Junger J, Petrowski K, Ladwig KH, Lambertus F, Michal M, Weber C, de Zwaan M, Herrmann-Lingen C, Ronel J, Albus C. Somatic and sociodemographic predictors of depression outcome among depressed patients with coronary artery disease - a secondary analysis of the SPIRR-CAD study. BMC Psychiatry. 2019 Feb 4;19(1):57. doi: 10.1186/s12888-019-2026-6.
- Derived from this study: PubMed 29602324Sollner W, Muller MM, Albus C, Behnisch R, Beutel ME, de Zwaan M, Fritzsche K, Habermeier A, Hellmich M, Jordan J, Junger J, Ladwig KH, Michal M, Petrowski K, Ronel J, Stein B, Weber C, Weber R, Herrmann-Lingen C. The relationship between attachment orientations and the course of depression in coronary artery disease patients: A secondary analysis of the SPIRR-CAD trial. J Psychosom Res. 2018 May;108:39-46. doi: 10.1016/j.jpsychores.2018.02.014. Epub 2018 Feb 24.
- Derived from this study: PubMed 29332628Orth-Gomer K, Deter HC, Grun AS, Herrmann-Lingen C, Albus C, Bosbach A, Ladwig KH, Ronel J, Sollner W, de Zwaan M, Petrowski K, Weber C; SPIRR-CAD Study Group. Socioeconomic factors in coronary artery disease - Results from the SPIRR-CAD study. J Psychosom Res. 2018 Feb;105:125-131. doi: 10.1016/j.jpsychores.2017.12.005. Epub 2017 Dec 5.
- Derived from this study: PubMed 29078170Lambertus F, Herrmann-Lingen C, Fritzsche K, Hamacher S, Hellmich M, Junger J, Ladwig KH, Michal M, Ronel J, Schultz JH, Vitinius F, Weber C, Albus C. Prevalence of mental disorders among depressed coronary patients with and without Type D personality. Results of the multi-center SPIRR-CAD trial. Gen Hosp Psychiatry. 2018 Jan-Feb;50:69-75. doi: 10.1016/j.genhosppsych.2017.10.001. Epub 2017 Oct 7.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Christoph Herrmann-Lingen, MD principal investigator
University of Goettingen, Dept. of Psychosomatic Medicine and Psychotherapy
Christian Albus, MD principal investigator
University of Cologne, Dept. of Psychosomatics and Psychotherapy
10 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Psychotherapy, Information session and Usual cardiological care in people with Depression and Coronary Artery Disease, run by University of Göttingen at 10 sites in Germany.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 30 Aug 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 10 sites in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Changes from baseline to 18 months in depressive symptoms (HADS-D) (time frame: 18 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00705965, which also lists 7 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Aug 2016.