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Psychokardiologie: Praxisrelevante Erkenntnisse und Handlungsempfehlungen.
Psychocardiology: Clinically relevant recommendations regarding selected cardiovascular diseases.
Dtsch. Med. Wochenschr. 139, 596-601 (2014)
Psychosocial risk factors (work stress, low socioeconomic status, impaired social support, anger, anxiety and depression), certain personality traits (e. g. hostility) and post-traumatic stress disorders may negatively influence the incidence and course of multiple cardiovascular disease conditions. Systematic screening for these factors may help to adequately assess the psychosocial risk pattern of a given patient and may also contribute to the treatment of these patients. Recommendations for treatment are based on current guidelines.The physician-patient interaction should basically follow the principle of a patient centered communication and should gender and age specific aspects into consideration. Integrated biopsychosocial care is an effective, low threshold option to treat psycho-social risk factors and should be offered on a regular basis.Patients with high blood pressure may profit from relaxation programs and biofeedback procedures (however with moderate success). An individually adjusted multimodal treatment strategy should be offered to patients with coronary heart disease, heart failure and after heart surgery. It may incorporate educational tools, exercise therapy, motivational modules, relaxation and stress management programs. In case of affective comorbidity, psychotherapy may be indicated. Anti-depressant pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs) in the first line should only be offered to patients with at least moderate severe depressive episodes. Psychotherapy and SSRIs, particularly sertraline, have been proven to be safe and effective with regard to improvements of the patient's quality of life. A prognostic benefit has not been clearly proven so far. Patients with an implanted cardioverter/defibrillator (ICD) should receive psychosocial support on a regular basis. Concomitant psychotherapy and/or psychopharmacotherapy (SSRIs) should be offered in case of a severe mental comorbidity. Generally, tricyclic antidepressants should be avoided in cardiac patients because of adverse side effects.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Herz-kreislauf-erkrankungen ; Psychosoziale Risikofaktoren ; Depression ; Angst ; Psychotherapie ; Psychopharmakotherapie ; Cardiovascular Disorders ; Psychosocial Risk Factors ; Depression ; Anxiety ; Psychotherapy ; Pharmacotherapy; Coronary-heart-disease; Implantable Cardioverter-defibrillators; Quality-of-life; Posttraumatic-stress-disorder; Acute Myocardial-infarction; Randomized-controlled-trial; Psychosocial Risk-factors; Atrial-fibrillation; Secondary Prevention; Depressive Symptoms
Language
german
Publication Year
2014
HGF-reported in Year
2014
ISSN (print) / ISBN
0012-0472
e-ISSN
1439-4413
Quellenangaben
Volume: 139,
Issue: 12,
Pages: 596-601
Publisher
Thieme
Publishing Place
Stuttgart
Reviewing status
Peer reviewed
Institute(s)
Institute of Epidemiology (EPI)
POF-Topic(s)
30202 - Environmental Health
Research field(s)
Genetics and Epidemiology
PSP Element(s)
G-504000-003
PubMed ID
24619718
WOS ID
WOS:000333454500010
Scopus ID
84896126066
Erfassungsdatum
2014-03-25