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Title: A controlled trial of the effectiveness of a brief psychological intervention in patients with high cholesterol levels.
Author: Papadatou, Aspasia.
ISNI:       0000 0001 3466 8277
Awarding Body: University of Herfordshire
Current Institution: University of Hertfordshire
Date of Award: 2001
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Most research on hypercholesterolemia concerns the association of cholesterol to stress, with very few references to psychotherapeutic interventions, which are on small and motivated samples. Especially in Greece, no research has been done either on the association of cholesterol to psychological factors or the treatment of cholesterol by psychological interventions. The present study examined the effectiveness of a brief psychological intervention in decreasing high or borderline cholesterol levels. Fifty-eight hypercholesterolemic individuals were recruited for the study. This sample was a part of a group of 6,000 Athenian adults used in a long-term prospective study of cardiovascular diseases and their risk factors. Participants were partially randomised for age, sex and cholesterol into an intervention and a control group. A brief group psychological intervention was used which focused on the realisation of sources of stress and the expression of "unacceptable" thoughts and feelings. The theoretical background was psychodynamic and systemic. Intervention groups met weekly for 1 /2 hour sessions, while the control groups were invited to come to the hospital once a month for the first 3 months. The treatment outcome was assessed using blood tests of cholesterol, high density lipoproteines (HDL), low density lipoproteines (LDL), psychological tests and a questionnaire evaluating the group intervention. Participants were followed up for 1 year and were assessed at 3- month, 6-month and 1-year intervals. A statistically significant difference was found in the intervention group between the first and the second measurements of cholesterol, HDL and LDL. Also, the intervention group was found to have significantly greater decrease in cholesterol and LDL than the control group when the change scores between the initial and first follow-up measurements were compared. Significant changes were found in cholesterol, HDL and LDL in the third follow-up in the control group, which is difficult to vii explain since no association was found with any psychological or lifestyle parameters examined. No significant differences between the intervention and the control group were found on the psychological measures used in the study. However, correlations were found between decrease in cholesterol at the 1" follow-up and patients' satisfaction with the group process. The group process was analysed as well as case studies of two group members who responded well to the intervention and two who did not. These analyses suggested that participants were confronting a struggle between strong moral, social and familial obligations and their own attitudes towards life, which created strong feelings of guilt, anger and tension. Their unfamiliarity with psychotherapy and their motivation to obtain symptom relief seemed to influence the outcome of the intervention. A combination of health education and brief group psychotherapy is suggested. However, further evidence is required to support the effectiveness of brief psychological intervention in the decrease in cholesterol as well as the finding of the significant decrease in cholesterol in the control group at the 1- year follow-up.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Hypercholesterolemia; Psychotherapy Psychology Medicine