Document Type : Original Article
Authors
- . Navid Mirzakhani Araghi
- . Mehdi Alizadeh Zarei 1
- . Shafagh Saei 2
- . Hamid Reza Yousefi Nodeh 3
- . Ebrahim Mahmoudi 4
1 Department of Occupational Therapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
2 Department of Occupational Therapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Department of Occupational Therapy, Student Research Committee, School of Rehabilitation, Shahid Beheshti Medical University, Tehran, Iran
3 Department of Occupational Therapy, Student Research Committee, School of Rehabilitation, Shahid Beheshti Medical University, Tehran, Iran
4 School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
Abstract
BACKGROUND: COVID‑19 virus is on the rise globally, and people with the disease experience a
variety of physical and mental problems. According to studies, depression can be a complication of
the virus. So far, limited measures have been taken to prevent and treat emotional–psychological
complications of COVID‑19. The aim of this study was to evaluate the effect of online cognitive
behavioral therapy (CBT) on depressive symptoms in recovered patients with COVID‑19.
MATERIALS AND METHODS: This study was conducted in a quasi‑experimental design. A sample
of 150 recovered patients with COVID‑19 who referred to Imam Reza Hospital in Tabriz city, were
selected by random sampling method. The patients’ emotional–psychological status was assessed
by the Beck Depression Inventory, and they entered the treatment process according to the inclusion
criteria. As a therapeutic intervention, a scientific and valid approach called CBT was implemented,
which two occupational therapists performed in eight treatment sessions in the context of a social
communication application. Paired sample t‑test was used to analyze the time sequence of quantitative
data due to its normality.
RESULTS: After the last session of the intervention, the effect of this therapeutic approach on reducing
the depressive symptoms of patients was evaluated. According to the findings, the Beck score of the
participants decreased significantly after the intervention (MD = ‒45/9, P < 0/001).
CONCLUSION: Therefore, in order to promote the recovery of patients with COVID‑19 and help
health authorities to develop preventive measures and effective treatment of emotional–psychological
problems caused by this virus, it is recommended to use the online CBT approach.
Keywords
than just the common cold. JAMA 2020;323:707‑8.
2. Lu W, Wang H, Lin Y, Li L. Psychological status of medical
workforce during the COVID‑19 pandemic: A cross‑sectional
study. Psychiatry Res 2020;288:112936.
3. Shigemura J, Ursano RJ, Morganstein JC, Kurosawa M,
Benedek DM. Public responses to the novel 2019 coronavirus
(2019-nCoV) in Japan: Mental health consequences and target
populations. Psychiatry Clin Neurosci 2020;74:281.
4. Bondade S, Hosthota A, Basavaraju V. Stressful life events and
psychiatric comorbidity in acne‑A case control study. Asia Pac
Psychiatry 2019;11:e12340.
5. Ren F, Yu X, Dang W, Niu W, Zhou T, Lin Y, et al. Depressive
symptoms in Chinese assembly-line migrant workers: A case
study in the shoe-making industry. Asia Pacific Psychiatry
2019;11:e12332.
6. Xiang YT, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al.
Timely mental health care for the 2019 novel coronavirus outbreak
is urgently needed. Lancet Psychiatry 2020;7:228‑9.
7. Li W, Yang Y, Liu ZH, Zhao YJ, Zhang Q, Zhang L, et al.
Progression of mental health services during the COVID‑19
outbreak in China. Int J Biol Sci 2020;16:1732‑8.
8. Leonard BE. The immune system, depression and the action of
antidepressants. Prog Neuropsychopharmacol Biol Psychiatry
2001;25:767‑80.
9. Wu KK, Chan SK, Ma TM. Posttraumatic stress, anxiety,
and depression in survivors of severe acute respiratory
syndrome (SARS). J Trauma Stress 2005;18:39‑42.
10. Mak IW, Chu CM, Pan PC, Yiu MG, Chan VL. Long‑term
psychiatric morbidities among SARS survivors. Gen Hosp
Psychiatry 2009;31:318‑26.
11. Ma YF, Li W, Deng HB, Wang L, Wang Y, Wang PH, et al.
Prevalence of depression and its association with quality of
life in clinically stable patients with COVID‑19. J Affect Disord
2020;275:145‑8.
12. Zhao Q, Hu C, Feng R, Yang Y. Investigation of the mental
health of patients with COVID‑19. Chinese Journal of Neurology.
2020;53 (6).
13. Zamanian M, Ahmadi D, Sindarreh S, Aleebrahim F,
Vardanjani HM, Faghihi SH, et al. Fear and rumor associated
with COVID‑19 among Iranian adults, 2020. J Educ Health Promot
2020;9:355.
14. Duan L, Zhu G. Psychological interventions for people affected by
the COVID‑19 epidemic. The lancet psychiatry. 2020;7 (4):300‑2.
15. Ratajska A, Zurawski J, Healy B, Glanz BI. Computerized
Cognitive Behavioral Therapy for Treatment of Depression in
Multiple Sclerosis: A Narrative Review of Current Findings
and Future Directions. International journal of MS care.
2019;21 (3):113‑23.
16. Li J, Li X, Jiang J, Xu X, Wu J, Xu Y, et al. The effect of cognitive
behavioral therapy on depression, anxiety, and stress in patients
with COVID‑19: A randomized controlled trial. Front Psychiatry
2020;11:580827.
17. Newman MG, Szkodny LE, Llera SJ, Przeworski A. A review
of technology‑assisted self‑help and minimal contact therapies
for anxiety and depression: Is human contact necessary for
therapeutic efficacy? Clin Psychol Rev 2011;31:89‑103.
18. Butler AC, Chapman JE, Forman EM, Beck AT. The empirical
status of cognitive‑behavioral therapy: A review of meta‑analyses.
Clin Psychol Rev 2006;26:17‑31.
19. Ye YY, Zhang YF, Chen J, Liu J, Li XJ, Liu YZ, et al. Internet‑based
cognitive behavioral therapy for insomnia (ICBT‑i) improves
comorbid anxiety and depression – A meta‑analysis of
randomized controlled trials. PLoS One 2015;10:e0142258.
20. Baumeister H, Reichler L, Munzinger M, Lin J. The impact of
guidance on Internet‑based mental health interventions – A
systematic review. Internet Intervent 2014;1:205‑15.
21. Nekouei ZK, Yousefy A, Manshaee G. Cognitive‑behavioral
therapy and quality of life: An experience among cardiac patients.
J Educ Health Promot 2012;1:2.
22. Jo SA, Park MH, Jo I, Ryu SH, Han C. Usefulness of Beck
Depression Inventory (BDI) in the Korean elderly population.
Int J Geriatr Psychiatry 2007;22:218‑23.
23. Segal DL, Coolidge FL, Cahill BS, O’Riley AA. Psychometric
properties of the Beck Depression Inventory II (BDI‑II) among
community‑dwelling older adults. Behav Modif 2008;32:3‑20.
24. Arnau RC, Meagher MW, Norris MP, Bramson R. Psychometric
evaluation of the Beck Depression Inventory‑II with primary care
medical patients. Health Psychol 2001;20:112‑9.
25. Forkmann T, Vehren T, Boecker M, Norra C, Wirtz M, Gauggel S.
Sensitivity and specificity of the beck depression inventory in
cardiologic inpatients: How useful is the conventional cut‑off score? J Psychosom Res 2009;67:347‑52.
26. Hamidi R, Fekrizadeh Z, Azadbakht M, Garmaroudi G,
Taheri Tanjani P, Fathizadeh S, et al. Validity and reliability Beck
Depression Inventory‑II among the Iranian elderly Population.
J Sabzevar Uni Med Sci 2015;22:189‑98.
27. Sudak DM. Cognitive behavioral therapy for depression. Psychiatr
Clin North Am 2012;35:99‑110.
28. Beck JS, Beck AT. Cognitive Therapy: Basics and Beyond.
New York: Guilford press; 1995.
29. Padesky C, Greenberger D. Mind Over Mood: Clinician’s Guide.
New York: Guilford Press; 1995.
30. Cuijpers P, Berking M, Andersson G, Quigley L, Kleiboer A,
Dobson KS. A meta‑analysis of cognitive‑behavioural therapy for
adult depression, alone and in comparison with other treatments.
Can J Psychiatry 2013;58:376‑85.
31. Vasile C. CBT and medication in depression (Review). Exp Ther
Med 2020;20:3513‑6.
32. Ellis LA, Campbell AJ, Sethi S, O’Dea BM. Comparative
randomized trial of an online cognitive‑behavioral therapy
program and an online support group for depression and anxiety.
J Cyber Ther Rehabil 2011;4:461‑7.
33. DeRubeis RJ, Hollon SD, Amsterdam JD, Shelton RC, Young PR,
Salomon RM, et al. Cognitive therapy vs. medications in the
treatment of moderate to severe depression. Arch Gen Psychiatry
2005;62:409‑16.
34. Karyotaki E, Riper H, Twisk J, Hoogendoorn A, Kleiboer A,
Mira A, et al. Efficacy of self‑guided internet‑based cognitive
behavioral therapy in the treatment of depressive symptoms:
A meta‑analysis of individual participant data. JAMA Psychiatry
2017;74:351‑9.
35. Norlund F, Wallin E, Olsson EMG, WallertJ, Burell G, von Essen L,
et al. Internet‑Based cognitive behavioral therapy for symptoms of
depression and anxiety among patients with a recent myocardial
infarction: The U‑CARE heart randomized controlled trial. J Med
Internet Res 2018;20:e88.
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