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Post-traumatic Stress Disorder: Emerging Risk Factor and Mechanisms

  • Roland von KänelEmail author
  • Marie-Louise Gander Ferrari
Chapter

Abstract

The psychological impact of man-made and natural disaster-related traumatic ­experiences is well known. For instance, in former prisoners of war as well as in survivors of terrorist attacks and earthquakes, trauma-related distress and psychiatric diseases such as post-traumatic stress disorder (PTSD), anxiety disorder, and major depressive disorders are prevalent.

Keywords

Clinical management Emerging risk factor Mechanisms Pathophysiologic links Post-traumatic stress disorder Predictors Prevalence Therapeutic approach 

Notes

Funding/Support

Own work cited in this chapter was supported by an unrestricted grant of Pfizer AG Switzerland and by a research grant of the University of Bern, Switzerland.

References

  1. 1.
    Engdahl B, Dikel TN, Eberly R, Blank A Jr. Comorbidity and course of psychiatric disorders in a community sample of former prisoners of war. Am J Psychiatry. 1998;155:1740-1745.PubMedGoogle Scholar
  2. 2.
    Silver RC, Holman EA, McIntosh DN, Poulin M, Gil-Rivas V. Nationwide longitudinal study of psychological responses to September 11. JAMA. 2002;288:1235-1244.PubMedCrossRefGoogle Scholar
  3. 3.
    Lai TJ, Chang CM, Connor KM, Lee LC, Davidson JR. Full and partial PTSD among ­earthquake survivors in rural Taiwan. J Psychiatr Res. 2004;38:313-322.PubMedCrossRefGoogle Scholar
  4. 4.
    Gurevich M, Devins GM, Rodin GM. Stress response syndromes and cancer: conceptual and assessment issues. Psychosomatics. 2002;43:259-281.PubMedCrossRefGoogle Scholar
  5. 5.
    Tedstone JE, Tarrier N. Posttraumatic stress disorder following medical illness and treatment. Clin Psychol Rev. 2003;23:409-448.PubMedCrossRefGoogle Scholar
  6. 6.
    Spindler H, Pedersen SS. Posttraumatic stress disorder in the wake of heart disease: prevalence, risk factors, and future research directions. Psychosom Med. 2005;67:715-723.PubMedCrossRefGoogle Scholar
  7. 7.
    Schelling G. Post-traumatic stress disorder in somatic disease: lessons from critically ill patients. Prog Brain Res. 2008;167:229-237.PubMedCrossRefGoogle Scholar
  8. 8.
    Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14:245-258.PubMedCrossRefGoogle Scholar
  9. 9.
    Boscarino JA. Diseases among men 20 years after exposure to severe stress: implications for clinical research and medical care. Psychosom Med. 1997;59:605-614.PubMedGoogle Scholar
  10. 10.
    Boscarino JA. Posttraumatic stress disorder and physical illness: results from clinical and ­epidemiologic studies. Ann N Y Acad Sci. 2004;1032:141-153.PubMedCrossRefGoogle Scholar
  11. 11.
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington DC: APA; 1994.Google Scholar
  12. 12.
    Schnyder U, Moergeli H, Trentz O, Klaghofer R, Buddeberg C. Prediction of psychiatric ­morbidity in severely injured accident victims at one-year follow-up. Am J Respir Crit Care Med. 2001;164:653-656.PubMedCrossRefGoogle Scholar
  13. 13.
    Yehuda R. Post-traumatic stress disorder. N Engl J Med. 2002;346:108-114.PubMedCrossRefGoogle Scholar
  14. 14.
    Foa EB, Cashman L, Jaycox L, Perry K. Validation of a self-report measure of posttraumatic stress disorder: the Posttraumatic Diagnostic Scale. Psychol Assess. 1997;9:445-451.CrossRefGoogle Scholar
  15. 15.
    Horowitz M, Wilner N, Alvarez W. Impact of event scale: a measure of subjective stress. Psychosom Med. 1979;41:209-218.PubMedGoogle Scholar
  16. 16.
    Blake DD, Weathers FW, Nagy LM, et al. The development of a Clinician-Administered PTSD Scale. J Trauma Stress. 1995;8:75-90.PubMedCrossRefGoogle Scholar
  17. 17.
    Hepp U, Gamma A, Milos G, et al. Prevalence of exposure to potentially traumatic events and PTSD. The Zurich Cohort Study. Eur Arch Psychiatry Clin Neurosci. 2006;256:151-158.PubMedCrossRefGoogle Scholar
  18. 18.
    Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52:1048-1060.PubMedCrossRefGoogle Scholar
  19. 19.
    Gander ML, von Känel R. Myocardial infarction and post-traumatic stress disorder: frequency, outcome, and atherosclerotic mechanisms. Eur J Cardiovasc Prev Rehabil. 2006;13:165-172.PubMedCrossRefGoogle Scholar
  20. 20.
    Guler E, Schmid JP, Wiedemar L, Saner H, Schnyder U, von Känel R. Clinical diagnosis of posttraumatic stress disorder after myocardial infarction. Clin Cardiol. 2009;32:125-129.PubMedCrossRefGoogle Scholar
  21. 21.
    Abbas CC, Schmid JP, Guler E, et al. Trajectory of posttraumatic stress disorder caused by myocardial infarction: a two-year follow-up study. Int J Psychiatry Med. 2009;39:359-376.PubMedCrossRefGoogle Scholar
  22. 22.
    Wikman A, Bhattacharyya M, Perkins-Porras L, Steptoe A. Persistence of posttraumatic stress symptoms 12 and 36 months after acute coronary syndrome. Psychosom Med. 2008;70:764-772.PubMedCrossRefGoogle Scholar
  23. 23.
    Sears SF Jr, Conti JB. Quality of life and psychological functioning of ICD patients. Heart. 2002;87:488-493.PubMedCrossRefGoogle Scholar
  24. 24.
    Kutz I, Shabtai H, Solomon Z, Neumann M, David D. Post-traumatic stress disorder in ­myocardial infarction patients: prevalence study. Isr J Psychiatry Relat Sci. 1994;31:48-56.PubMedGoogle Scholar
  25. 25.
    Bennett P, Brooke S. Intrusive memories, post-traumatic stress disorder and myocardial ­infarction. Br J Clin Psychol. 1999;38:411-416.PubMedCrossRefGoogle Scholar
  26. 26.
    Chung MC, Berger Z, Rudd H. Coping with posttraumatic stress disorder and comorbidity after myocardial infarction. Compr Psychiatry. 2008;49:55-64.PubMedCrossRefGoogle Scholar
  27. 27.
    Ginzburg K. Life events and adjustment following myocardial infarction: a longitudinal study. Soc Psychiatry Psychiatr Epidemiol. 2006;41:825-831.PubMedCrossRefGoogle Scholar
  28. 28.
    Bennett P, Conway M, Clatworthy J, Brooke S, Owen R. Predicting post-traumatic symptoms in cardiac patients. Heart Lung. 2001;30:458-465.PubMedCrossRefGoogle Scholar
  29. 29.
    Ginzburg K, Solomon Z, Bleich A. Repressive coping style, acute stress disorder, and ­posttraumatic stress disorder after myocardial infarction. Psychosom Med. 2002;64:748-757.PubMedCrossRefGoogle Scholar
  30. 30.
    Wiedemar L, Schmid JP, Müller J, et al. Prevalence and predictors of posttraumatic stress disorder in patients with acute myocardial infarction. Heart Lung. 2008;37:113-121.PubMedCrossRefGoogle Scholar
  31. 31.
    Ginzburg K, Solomon Z, Dekel R, Bleich A. Longitudinal study of acute stress disorder, ­posttraumatic stress disorder and dissociation following myocardial infarction. J Nerv Ment Dis. 2006;194:945-950.PubMedCrossRefGoogle Scholar
  32. 32.
    Ginzburg K, Solomon Z, Koifman B, et al. Trajectories of posttraumatic stress disorder ­following myocardial infarction: a prospective study. J Clin Psychiatry. 2003;64:1217-1223.PubMedCrossRefGoogle Scholar
  33. 33.
    Pedersen SS, Middel B, Larsen ML. Posttraumatic stress disorder in first-time myocardial infarction patients. Heart Lung. 2003;32:300-307.PubMedCrossRefGoogle Scholar
  34. 34.
    Whitehead DL, Perkins-Porras L, Strike PC, Steptoe A. Post-traumatic stress disorder in patients with cardiac disease: predicting vulnerability from emotional responses during admission for acute coronary syndromes. Heart. 2006;92:1225-1229.PubMedCrossRefGoogle Scholar
  35. 35.
    Chung MC, Berger Z, Rudd H. Comorbidity and personality traits in patients with different levels of posttraumatic stress disorder following myocardial infarction. Psychiatry Res. 2007;152:243-252.PubMedCrossRefGoogle Scholar
  36. 36.
    Pedersen SS, Denollet J. Validity of the type D personality construct in Danish post-MI patients and healthy controls. J Psychosom Res. 2004;57:265-272.PubMedCrossRefGoogle Scholar
  37. 37.
    Whitehead DL, Strike P, Perkins-Porras L, Steptoe A. Frequency of distress and fear of dying during acute coronary syndromes and consequences for adaptation. Am J Cardiol. 2005;96:1512-1516.PubMedCrossRefGoogle Scholar
  38. 38.
    Roberge MA, Dupuis G, Marchand A. Acute stress disorder after myocardial infarction: ­prevalence and associated factors. Psychosom Med. 2008;70:1028-1034.PubMedCrossRefGoogle Scholar
  39. 39.
    Gamper G, Willeit M, Sterz F, et al. Life after death: posttraumatic stress disorder in survivors of cardiac arrest–prevalence, associated factors, and the influence of sedation and analgesia. Crit Care Med. 2004;32:378-383.PubMedCrossRefGoogle Scholar
  40. 40.
    Shalev A, Bleich A, Ursano RJ. Posttraumatic stress disorder: somatic comorbidity and effort tolerance. Psychosomatics. 1990;31:197-203.PubMedCrossRefGoogle Scholar
  41. 41.
    Falger PR, Op den Velde W, Hovens JE, Schouten EG, De Groen JH, Van Duijn H. Current posttraumatic stress disorder and cardiovascular disease risk factors in Dutch Resistance ­veterans from World War II. Psychother Psychosom. 1992;57:164-171.PubMedCrossRefGoogle Scholar
  42. 42.
    McFarlane AC, Atchison M, Rafalowicz E, Papay P. Physical symptoms in post-traumatic stress disorder. J Psychosom Res. 1994;38:715-726.PubMedCrossRefGoogle Scholar
  43. 43.
    Cwikel J, Abdelgani A, Goldsmith JR, Quastel M, Yevelson II. Two-year follow up study of stress-related disorders among immigrants to Israel from the Chernobyl area. Environ Health Perspect. 1997;105(suppl 6):1545-1550.PubMedCrossRefGoogle Scholar
  44. 44.
    Boscarino JA, Chang J. Electrocardiogram abnormalities among men with stress-related ­psychiatric disorders: implications for coronary heart disease and clinical research. Ann Behav Med. 1999;21:227-234.PubMedCrossRefGoogle Scholar
  45. 45.
    Schnurr PP, Spiro A 3rd, Paris AH. Physician-diagnosed medical disorders in relation to PTSD symptoms in older male military veterans. Health Psychol. 2000;19:91-97.PubMedCrossRefGoogle Scholar
  46. 46.
    Dobie DJ, Kivlahan DR, Maynard C, Bush KR, Davis TM, Bradley KA. Posttraumatic stress disorder in female veterans: association with self-reported health problems and functional impairment. Arch Intern Med. 2004;164:394-400.PubMedCrossRefGoogle Scholar
  47. 47.
    Sawchuk CN, Roy-Byrne P, Goldberg J, et al. The relationship between post-traumatic stress disorder, depression and cardiovascular disease in an American Indian tribe. Psychol Med. 2005;35:1785-1794.PubMedCrossRefGoogle Scholar
  48. 48.
    Boscarino JA. Posttraumatic stress disorder and mortality among U.S. Army Veterans 30 years after military service. Ann Epidemiol. 2006;16:248-256.PubMedCrossRefGoogle Scholar
  49. 49.
    Kubzansky LD, Koenen KC, Spiro A 3rd, Vokonas PS, Sparrow D. Prospective study of ­posttraumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study. Arch Gen Psychiatry. 2007;64:109-116.PubMedCrossRefGoogle Scholar
  50. 50.
    Boscarino JA. A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: implications for surveillance and prevention. Psychosom Med. 2008;70:668-676.PubMedCrossRefGoogle Scholar
  51. 51.
    Kubzansky LD, Koenen KC, Jones C, Eaton WW. A prospective study of posttraumatic stress disorder symptoms and coronary heart disease in women. Health Psychol. 2009;28:125-130.PubMedCrossRefGoogle Scholar
  52. 52.
    Shemesh E, Yehuda R, Milo O, et al. Posttraumatic stress, nonadherence, and adverse outcome in survivors of a myocardial infarction. Psychosom Med. 2004;66:521-526.PubMedCrossRefGoogle Scholar
  53. 53.
    Ladwig KH, Baumert J, Marten-Mittag B, Kolb C, Zrenner B, Schmitt C. Posttraumatic stress symptoms and predicted mortality in patients with implantable cardioverter defibrillators: results from the prospective living with an implanted cardioverter defibrillator study. Arch Gen Psychiatry. 2008;65:1324-1330.PubMedCrossRefGoogle Scholar
  54. 54.
    Koenen KC, Aiello AE, Bakshis E, et al. Modification of the association between serotonin transporter genotype and risk of posttraumatic stress disorder in adults by county-level social environment. Am J Epidemiol. 2009;169:704-711.PubMedCrossRefGoogle Scholar
  55. 55.
    Nakatani D, Sato H, Sakata Y, et al. Influence of serotonin transporter gene polymorphism on depressive symptoms and new cardiac events after acute myocardial infarction. Am Heart J. 2005;150:652-658.PubMedCrossRefGoogle Scholar
  56. 56.
    Rozanski A, Blumenthal JA, Davidson KW, Saab PG, Kubzansky L. The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging field of behavioral cardiology. J Am Coll Cardiol. 2005;45:637-651.PubMedCrossRefGoogle Scholar
  57. 57.
    von Känel R, Kraemer B, Saner H, Schmid JP, Abbas CC, Begré S. Posttraumatic stress ­disorder and dyslipidemia: previous research and novel findings from patients with PTSD caused by myocardial infarction. World J Biol Psychiatry. 2010;11:141-147.CrossRefGoogle Scholar
  58. 58.
    Shemesh E, Rudnick A, Kaluski E, et al. A prospective study of posttraumatic stress symptoms and nonadherence in survivors of a myocardial infarction (MI). Gen Hosp Psychiatry. 2001;23:215-222.PubMedCrossRefGoogle Scholar
  59. 59.
    Matthews KA, Zhu S, Tucker DC, Whooley MA. Blood pressure reactivity to psychological stress and coronary calcification in the Coronary Artery Risk Development in Young Adults Study. Hypertension. 2006;47:391-395.PubMedCrossRefGoogle Scholar
  60. 60.
    Spivak B, Shohat B, Mester R, et al. Elevated levels of serum interleukin-1 beta in combat-related posttraumatic stress disorder. Biol Psychiatry. 1997;42:345-348.PubMedCrossRefGoogle Scholar
  61. 61.
    Maes M, Lin AH, Delmeire L, et al. Elevated serum interleukin-6 (IL-6) and IL-6 receptor concentrations in posttraumatic stress disorder following accidental man-made traumatic events. Biol Psychiatry. 1999;45:833-839.PubMedCrossRefGoogle Scholar
  62. 62.
    Baker DG, Ekhator NN, Kasckow JW, et al. Plasma and cerebrospinal fluid interleukin-6 ­concentrations in posttraumatic stress disorder. Neuroimmunomodulation. 2001;9:209-217.PubMedCrossRefGoogle Scholar
  63. 63.
    Kawamura N, Kim Y, Asukai N. Suppression of cellular immunity in men with a past history of posttraumatic stress disorder. Am J Psychiatry. 2001;158:484-486.PubMedCrossRefGoogle Scholar
  64. 64.
    Miller RJ, Sutherland AG, Hutchison JD, Alexander DA. C-reactive protein and interleukin-6 receptor in post-traumatic stress disorder: a pilot study. Cytokine. 2001;13:253-255.PubMedCrossRefGoogle Scholar
  65. 65.
    Rohleder N, Joksimovic L, Wolf JM, Kirschbaum C. Hypocortisolism and increased ­glucocorticoid sensitivity of pro-inflammatory cytokine production in Bosnian war refugees with posttraumatic stress disorder. Biol Psychiatry. 2004;55:745-751.PubMedCrossRefGoogle Scholar
  66. 66.
    Sondergaard HP, Hansson LO, Theorell T. The inflammatory markers C-reactive protein and serum amyloid A in refugees with and without posttraumatic stress disorder. Clin Chim Acta. 2004;342:93-98.PubMedCrossRefGoogle Scholar
  67. 67.
    Tucker P, Ruwe WD, Masters B, et al. Neuroimmune and cortisol changes in selective serotonin reuptake inhibitor and placebo treatment of chronic posttraumatic stress disorder. Biol Psychiatry. 2004;56:121-128.PubMedCrossRefGoogle Scholar
  68. 68.
    Woods AB, Page GG, O’Campo P, Pugh LC, Ford D, Campbell JC. The mediation effect of posttraumatic stress disorder symptoms on the relationship of intimate partner violence and IFN-gamma levels. Am J Community Psychol. 2005;36:159-175.PubMedCrossRefGoogle Scholar
  69. 69.
    von Känel R, Hepp U, Buddeberg C, et al. Altered blood coagulation in patients with ­posttraumatic stress disorder. Psychosom Med. 2006;68:598-604.CrossRefGoogle Scholar
  70. 70.
    Song Y, Zhou D, Guan Z, Wang X. Disturbance of serum interleukin-2 and interleukin-8 levels in posttraumatic and non-posttraumatic stress disorder earthquake survivors in northern China. Neuroimmunomodulation. 2007;14:248-254.PubMedCrossRefGoogle Scholar
  71. 71.
    von Känel R, Hepp U, Kraemer B, et al. Evidence for low-grade systemic proinflammatory activity in patients with posttraumatic stress disorder. J Psychiatr Res. 2007;41:744-752.CrossRefGoogle Scholar
  72. 72.
    Gill J, Vythilingam M, Page GG. Low cortisol, high DHEA, and high levels of stimulated TNF-alpha, and IL-6 in women with PTSD. J Trauma Stress. 2008;21:530-539.PubMedCrossRefGoogle Scholar
  73. 73.
    von Känel R, Hepp U, Traber R, et al. Measures of endothelial dysfunction in plasma of patients with posttraumatic stress disorder. Psychiatry Res. 2008;158:363-373.CrossRefGoogle Scholar
  74. 74.
    von Känel R, Begré S, Abbas CC, Saner H, Gander ML, Schmid JP. Inflammatory biomarkers in patients with posttraumatic stress disorder caused by myocardial infarction and the role of depressive symptoms. Neuroimmunomodulation. 2010;17:39-46.CrossRefGoogle Scholar
  75. 75.
    von Känel R, Abbas CC, Begré S, Saner H, Gander ML, Schmid JP. Posttraumatic stress ­disorder and soluble cellular adhesion molecules at rest and in response to a trauma specific interview in patients after myocardial infarction. Psychiatry Res. 2010;179(3):312-317.CrossRefGoogle Scholar
  76. 76.
    Heim C, Nemeroff CB. Neurobiology of posttraumatic stress disorder. CNS Spectr. 2009;14(1 suppl 1):13-24.PubMedGoogle Scholar
  77. 77.
    Rohleder N, Karl A. Role of endocrine and inflammatory alterations in comorbid somatic diseases of post-traumatic stress disorder. Minerva Endocrinol. 2006;31:273-288.PubMedGoogle Scholar
  78. 78.
    Meewisse ML, Reitsma JB, de Vries GJ, Gersons BP, Olff M. Cortisol and post traumatic stress disorder in adults: systematic review and meta-analysis. Br J Psychiatry. 2007;191:387-392.PubMedCrossRefGoogle Scholar
  79. 79.
    Strawn JR, Geracioti TD. Noradrenergic dysfunction and the psychopharmacology of posttraumatic stress disorder. Depress Anxiety. 2008;25:260-271.PubMedCrossRefGoogle Scholar
  80. 80.
    von Känel R, Schmid JP, Abbas CC, Gander ML, Saner H, Begré S. Stress hormones in patients with posttraumatic stress disorder caused by myocardial infarction and role of comorbid depression. J Affect Disord. 2010;121:73-79.CrossRefGoogle Scholar
  81. 81.
    von Känel R, Dimsdale JE. Effects of sympathetic activation by adrenergic infusions on hemostasis in vivo. Eur J Haematol. 2000;65:357-369.CrossRefGoogle Scholar
  82. 82.
    von Känel R, Mills PJ, Fainman C, Dimsdale JE. Effects of psychological stress and psychiatric disorders on blood coagulation and fibrinolysis: a biobehavioral pathway to coronary artery disease? Psychosom Med. 2001;63:531-544.Google Scholar
  83. 83.
    Sack M, Hopper JW, Lamprecht F. Low respiratory sinus arrhythmia and prolonged psychophysiological arousal in posttraumatic stress disorder: heart rate dynamics and individual differences in arousal regulation. Biol Psychiatry. 2004;55:284-290.PubMedCrossRefGoogle Scholar
  84. 84.
    Tracey KJ. Physiology and immunology of the cholinergic antiinflammatory pathway. J Clin Invest. 2007;117:289-296.PubMedCrossRefGoogle Scholar
  85. 85.
    Rosas-Ballina M, Tracey KJ. Cholinergic control of inflammation. J Intern Med. 2009;265:663-679.PubMedCrossRefGoogle Scholar
  86. 86.
    von Känel R. Psychological distress and cardiovascular risk: what are the links [editorial]? J Am Coll Cardiol. 2008;52:2163-2165.CrossRefGoogle Scholar
  87. 87.
    Kubzansky LD, Koenen KC. Is posttraumatic stress disorder related to development of heart disease? An update. Cleve Clin J Med. 2009;76(suppl 2):S60-S65.PubMedCrossRefGoogle Scholar
  88. 88.
    Prins A, Ouimette PC, Kimerling R, et al. The Primary Care PTSD Screen (PC-PTSD): development and operating characteristics. Prim Care Psychiatry. 2004;9:9-14.CrossRefGoogle Scholar
  89. 89.
    Zohar J, Sonnino R, Juven-Wetzler A, Cohen H. Can posttraumatic stress disorder be prevented? CNS Spectr. 2009;14(1 suppl 1):44-51.PubMedGoogle Scholar
  90. 90.
    Rose S, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2002;2:CD000560.Google Scholar
  91. 91.
    Bisson J, Andrew M. Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2007;3:CD003388.Google Scholar
  92. 92.
    Friedman MJ. Posttraumatic stress disorder among military returnees from Afghanistan and Iraq. Am J Psychiatry. 2006;163:586-593.PubMedCrossRefGoogle Scholar
  93. 93.
    Stein DJ, Ipser J, McAnda N. Pharmacotherapy of posttraumatic stress disorder: a review of meta-analyses and treatment guidelines. CNS Spectr. 2009;14(1 suppl 1):25-31.PubMedGoogle Scholar
  94. 94.
    Shemesh E, Koren-Michowitz M, Yehuda R, et al. Symptoms of posttraumatic stress disorder in patients who have had a myocardial infarction. Psychosomatics. 2006;47:231-239.PubMedCrossRefGoogle Scholar
  95. 95.
    Glassman AH, O’Connor CM, Califf RM, et al. Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA. 2002;288:701-709.PubMedCrossRefGoogle Scholar
  96. 96.
    Lespérance F, Frasure-Smith N, Koszycki D, et al. Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: the Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial. JAMA. 2007;297:367-379.PubMedCrossRefGoogle Scholar
  97. 97.
    von Känel R, Begré S. Depression after myocardial infarction: unraveling the mystery of poor cardiovascular prognosis and role of beta-blocker therapy [editorial]. J Am Coll Cardiol. 2006;48:2215-2217.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2011

Authors and Affiliations

  • Roland von Känel
    • 1
    Email author
  • Marie-Louise Gander Ferrari
    • 1
  1. 1.Department of General Internal Medicine, Division of Psychosomatic Medicine, InselspitalBern University HospitalBernSwitzerland

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