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Cognitive and Behavioral Treatments for Anxiety and Depression in a Patient with an Implantable Cardioverter Defibrillator (ICD): A Case Report and Clinical Discussion

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Abstract

Implantable cardioverter-defibrillators (ICDs) are the treatment of choice for patients at risk for potentially life threatening arrhythmias. The associated stress of living with an implanted device and receiving ICD shock therapy has been noted to exert a psychological toll on the individual patient and family. Anxious and depressive symptomatology is frequently reported by these patients, thus creating a demand for tailored psychological interventions for this population. The current case report describes the components, delivery, and effectiveness of a targeted treatment approach for anxiety and depression in an individual with an ICD. Test results and interview data revealed significant improvements in multiple domains of cognitive, emotional, and behavioral functioning. Improvements in marital relations were also achieved. These treatment effects were maintained at follow-up and in the context of acute, medical stressors. Future clinical and research directions are also discussed.

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Acknowledgments

Preparation of this manuscript was supported in part by grants from the National Institutes of Health, National Institute of Neurological Disorders and Stroke (F31 NS049675) and National Institute of Child Health and Human Development, National Center for Rehabilitation Research (T32 HD007424).

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, University of Washington, Box 356490, Seattle, WA, 206-221-5688, USA

    Adam T. Hirsh

  2. Department of Psychology, East Carolina University, Greenville, NC, USA

    Samuel F. Sears Jr.

  3. Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, USA

    Jamie B. Conti

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  1. Adam T. Hirsh
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  2. Samuel F. Sears Jr.
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  3. Jamie B. Conti
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Correspondence to Adam T. Hirsh.

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Hirsh, A.T., Sears, S.F. & Conti, J.B. Cognitive and Behavioral Treatments for Anxiety and Depression in a Patient with an Implantable Cardioverter Defibrillator (ICD): A Case Report and Clinical Discussion. J Clin Psychol Med Settings 16, 270–279 (2009). https://doi.org/10.1007/s10880-009-9160-0

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