Psychosomatic aspects of coronary heart disease

Abstract

Coronary heart disease is one of the leading causes of death in industrialized countries. In its multifactorial pathogenesis psychosocial factors are considered cofactors influencing health behaviors and physiological processes. They are also potent triggers of acute myocardial infarctions. The heart disease itself can, in turn, lead to anxiety, denial, and depression. Psychological maladjustment, especially depression, can impair subjective well-being and clinical disease outcomes. It should therefore be identified systematically. Besides the somatic treatment, behavioral interventions can help patients to cope with stressors and control coronary risk factors. Psychotherapy and antidepressant medications are available for treating comorbid mental illnesses, especially depression. However, psychotherapy with cardiac patients has to take into account the particular characteristics and needs of these patients.