title: Mental Fitness for patients with acute coronary syndrome: A randomized clinical trial.
abstract: The aim of this study was to verify the efficacy of a manualized, cognitively oriented psychological intervention, called Mental Fitness, in improving the mental and physical health of patients with acute coronary syndrome (ACS). Mental Fitness is a small-group four-session treatment aimed at increasing awareness of one's own bodily perceptions, emotions, and thoughts and is overall tailored on participants' perception of control over their health.
  
  
  
  Prospective randomized controlled single-blind trial.
  
  
  
  Patients with ACS were recruited within a week from their acute cardiac event. Patients in the intervention group underwent one of two variants of Mental Fitness, depending on their perceived (internal or external) control over their health. Patients in the control group underwent standard treatment. All the patients were submitted to a clinical and psychological follow-up for 8 months.
  
  
  
  The patients who underwent the Mental Fitness intervention (N = 31) showed, compared to the control patients (N = 34), increased quality of life in its physical, psychological, social and environmental domains, more functional emotional and problem-centred coping strategies, and higher emotional awareness. They also showed improved high-density lipoprotein cholesterol, triglycerides, heart rate, and left ventricular ejection fraction compared to the controls. In addition, they were more successful in maintaining physical exercise.
  
  
  
  This study demonstrates the efficacy of Mental Fitness in modifying specific psychological and physical variables conditioning cardiological patients' prognosis. It also confirms the importance of differentiating psychological interventions based on the psychological characteristics of the patients. Statement of contribution What is already known on this subject? Traditional symptom-based interventions in heart disease are aimed at diagnosing and reducing psychological symptomatology (e.g., depression), but recent work has shown the usefulness of orienting psychological interventions to patients' representations of themselves and of the world and to how such representations influence their thoughts, feelings, and behaviours (e.g., Chiavarino et al., ). What does this study add? Mental Fitness, by working on awareness of bodily perceptions, emotions, and thoughts, leads to positive changes in physical and psychological health. Mental Fitness is a cost-effective psychological intervention that adds significantly to the effectiveness of standard medical care.
authors.affiliation: Center for Cognitive Science, University of Turin, Italy.|Salesian University Institute 'Rebaudengo' of Turin (IUSTO), Italy.
authors.forename: Claudia
authors.identifier: 0000-0001-9475-3764
authors.initials: C
authors.lastname: Chiavarino
authors.affiliation: Department of Cardiology, San Giovanni Battista Hospital, University of Turin, Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Cavallero
authors.affiliation: Center for Cognitive Science, University of Turin, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Rabellino
authors.affiliation: Department of Cardiology, San Giovanni Battista Hospital, University of Turin, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Palumbo
authors.affiliation: Center for Cognitive Science, University of Turin, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Bianchino
authors.affiliation: Department of Cardiology, San Giovanni Battista Hospital, University of Turin, Italy.
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
authors.affiliation: Department of Cardiology, San Giovanni Battista Hospital, University of Turin, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Bergerone
authors.affiliation: Center for Cognitive Science, University of Turin, Italy.|Department of Psychology, University of Turin, Italy.
authors.forename: Bruno G
authors.initials: BG
authors.lastname: Bara
mesh_terms: D054058:Acute Coronary Syndrome / Q000523:psychology* / Q000534:rehabilitation*; D000223:Adaptation, Psychological; D001364:Awareness; D015444:Exercise / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D016037:Single-Blind Method; D016896:Treatment Outcome
keywords: acute coronary syndrome; constructivistic approach; coping strategies; emotional awareness; medical outcome; quality of life