Abstract
Potential psychosocial risk factors of coronary heart disease (CHD) include type A personality, hostility and anger, alexithymia, type D personality, stress, depression, anxiety, denial, and social support. These patients often show psychopathology such as anxiety, depression, and delirium. Psychotherapeutic interventions and psychopharmacotherapy for these psychopathologies were reviewed. Psychotherapeutic interventions with heart disease patient are aimed at reducing anxiety and depression, enhancing compliance, and modifying risk factors. To treat them effectively, the clinician should look beyond the symptoms to their function and meaning. In psychopharmacotherapy, interactions between cardiac drugs and psychiatric drugs need to be examined in addition to cardiac side effects of psychiatric drugs and psychiatric side effects of cardiovascular drugs. For the mentally ill cardiac patients, it is desirable to combine psychiatric treatment with a cardiac rehabilitation. Physicians need to keep in mind that countertransference might influence the progress of a cardiac disease.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Sadock BJ, Sadock VA. Synopsis of psychiatry – behavioral sciences/clinical psychiatry. Philadelphia: Lippincott Williams & Wilkins; 2003. p. 829–31.
Hermann-Lingen C, Meinertz T. Psychosomatic aspects of coronary heart disease. Internist. 2010;51:826–35.
Lloyd GG, Cawly RH. Psychiatric morbidity in men one week after first acute myocardial infarction. Br Med J. 1978;2:1453–4.
Cassem NH, Hackett TP. Psychological aspects of myocardial infarction. Med Clin N Am. 1977;61:711–21.
Friedman M, Rosenman RH. Association of specific overt behavior pattern with blood and cardiovascular findings. J Am Med Assoc. 1959;169:1286–96.
Rosenman RH, Friedman M. Association of specific behavior pattern in women with blood and cardiovascular findings. Circulation. 1961;24:1173–84.
Kornitzer M, Kittel F, De Backer G. The Belgian Heart Disease Prevention Project: type A behavior pattern and the prevalence of coronary heart disease. Psychosom Med. 1981;43:133–45.
De Backer G, Kornitzer M, Kittel F. Behavior, stress and psychological traits as risk factors. Prev Med. 1983;12:32–6.
Eaker AD, Abbott RD, Kannel WB. Frequency of uncomplicated angina pectoris in type A compared with type B persons (the Framingham Study). Am J Cardiol. 1989;63:1042–5.
Blumenthal JA, Willams RB, Kong Y, et al. Type A behavior and angiographically documented coronary disease. Circulation. 1978;58:634–9.
Frank KA, Heller SS, Kornfeld DS, et al. Type A behavior pattern and coronary atherosclerosis. J Am Med Assoc. 1978;240:761–3.
Williams RB Jr, Haney TL, Lee KL. Type A behavior, hostility and coronary atherosclerosis. Psychosom Med. 1980;42:539–49.
Williams RB Jr, Barefoot JC, Haney TL, et al. Type A behavior and angiographically documented coronary atherosclerosis in a sample of 2,289 patients. Psychosom Med. 1988;50:139–52.
Dembroski TM, MacDougall JM, Williams RB, et al. J. Components of type A hostility and anger-in: relationship to angiographic findings. Psychosom Med. 1985;47:219–33.
MacDougall JM, Dembroski TM, Dimsdale JE, et al. Components of type A hostility and anger-in: further relationship to angiographic findings. Health Psychol. 1985;4:137–52.
Dimsdale JE, Hackett TP, Hutter AM, et al. Type A personality and extent of coronary atherosclerosis. Am J Cardiol. 1978;42:583–6.
Dimsdale JE, Hackett TP, Hutter AM, et al. Type A behavior and angiographic findings. J Psychosom Res. 1979;23:273–6.
Kornitzer M, Magotteau V, Degre V, et al. Angiographic findings and the type A behavior pattern assessed by means of the Bortner Scale. J Behav Med. 1982;5:313–9.
Scherwitz L, McKelvain R, Laman C, et al. Type A behavior, self-involvement and coronary atherosclerosis. Psychosom Med. 1983;45:47–57.
Cottington EM, Brock BM, House JS, et al. Psychosocial factors and blood pressure in the Michigan statewide blood pressure survey. Am J Epidemiol. 1985;121:515–29.
Diamond EL. The role of anger and hostility in essential hypertension and coronary heart disease. Psychol Bull. 1982;92:410–33.
Dimsdale JE, Pierce C, Schoenfield D, et al. Suppressed anger and blood pressure: the effect of race, sex, social class, obesity and age. Psychosom Med. 1986;48:430–5.
Hackett TP, Rosenbaum TF, Caddem NH. Cardiovascular disorders. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry, vol. 2. 5th ed. Baltimore: Williams & Wilkins; 1989.
Spielberger CD, Johnson EH, Russell SF, et al. The experience and expression of anger: construction and validation of an anger expression scale. In: Chesney MA, Rosenman RH, editors. Anger and hostility in cardiovascular and behavioral disorders. Washington, DC: Hemisphere; 1985.
Koh KB, Kim SJ. Comparison of anger between patients with essential hypertension and normal controls. Kor J Psychosom Med. 1995;3:19–27.
Jenkins CD, Rosenman RH, Friedman M. Components of the coronary-prone behavior pattern: their relation to silent myocardial infarction and blood lipids. J Chron Dis. 1966;19:599–606.
Hecker MHL, Chesney MA, Black GW, et al. Coronary-prone behaviors in the Western Collaborative Group Study. Psychosom Med. 1988;50:153–64.
Koh KB, Cho SY, Kim JW, et al. The relationship of anger expression and alexithymia with coronary artery stenosis in patients with coronary artery diseases. Yonsei Med J. 2004;45:181–6.
Siegman AW, Dembroski TM, Ringel N. Components of hostility and severity of coronary artery disease. Psychosom Med. 1987;49:127–35.
Helmer OC, Ragland DR, Syme SL. Hostility and coronary artery disease. Am J Epidemiol. 1990;123:112–22.
Tennant CC, Langeluddecke PM, Fulcher G, et al. Anger and other psychological factors in coronary atherosclerosis. Psychol Med. 1987;17:425–31.
Kauhanen J, Kasplan GA, Cohen RD, et al. Alexithymia may influence the diagnosis of coronary heart disease. Psychosom Med. 1994;56:237–44.
Katon W, Sullivan M, Clark M. Cardiovascular disorders. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry. 6th ed. Baltimore: Williams & Wilkins; 1995.
Denollet J. DS14: standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosom Med. 2005;67:89–97.
Denollet J, Sys S, Stroobant N, et al. Personality as independent predictor of long-term mortality in patients with coronary heart disease. Lancet. 1996;347:417–21.
Denollet J, Pedersen SS, Ong AT, et al. Social inhibition modulates the effect of negative emotions on cardiac prognosis following percutaneous coronary intervention in the drug-eluting stent era. Eur Heart J. 2006;27:171–7.
Denollet J, Martens E, Nyklícek I, et al. Clinical events in coronary patients who report low distress: adverse effect of repressive coping. Health Psychol. 2008;27:302–28.
Kim SJ, Koh KB. The relationship of stress perception with serum cholesterol in patients with essential hypertension. Kor J Psychosom Med. 1993;1:35–44.
Wittstein IS, Thiemann DR, Lima JA, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med. 2005;352:539–48.
Wittstein IS. The broken heart syndrome. Cleve Clin J Med. 2007;74(Suppl 1):S17–22.
Roh KS, Koh KB. The relationship between stress and coronary artery stenosis in patients with coronary artery diseases. Kor J Psychosom Med. 1998;6:126–35.
Rosengren A, Hawken S, Ounpuu S, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:953–62.
Kent LK, Shapiro PA. Depression and related psychological factors in heart disease. Harv Rev Psychiatry. 2009;17:377–88.
Frasure-Smith N, Lespérance F, Gravel G, et al. Social support, depression, and mortality during the first year after myocardial infarction. Circulation. 2000;101:1919–24.
Laghrissi-Thode F, Wagner WR, Pollock BG, et al. Elevated platelet factor 4 and betathromboglobulin plasma levels in depressed patients with ischemic heart disease. Biol Psychiatry. 1997;42:290–5.
Kawachi I, Colditz G, Ascherio A, et al. Prospective study of phobic anxiety and risk of coronary heart disease in men. Circulation. 1994;89:1992–7.
Kawachi I, Sparrow D, Vokonas P, et al. Symptoms of anxiety and risk of coronary heart disease. The Normative Aging Study. Circulation. 1994;90:2225–9.
Moser DK, Riegel B, McKinley S, et al. Impact of anxiety and perceived control on in-hospital complications after acute myocardial infarction. Psychosom Med. 2007;69:10–6.
Sullivan MD, LaCroix AZ, Spertus JA, et al. Five-year prospective study of the effects of anxiety and depression in patients with coronary artery disease. Am J Cardiol. 2000;86:1135–8. A6, A9
Ketterer MW, Huffman J, Lumley MA, et al. Five-year follow-up for adverse outcomes in males with at least minimally positive angiograms: importance of “denial” in assessing psychosocial risk factors. J Psychosom Res. 1998;44:241–50.
Levenson JL. Cardiovascular disease. In: Stoudemire A, Fogel BS, editors. Principles of medical psychiatry. New York: Grune & Stratton; 1987.
Burg MM, Barefoot J, Berkman L, et al. Low perceived social support and post-myocardial infarction prognosis in the enhancing recovery in coronary heart disease clinical trial: the effects of treatment. Psychosom Med. 2005;67:879–88.
Kim JW, Koh KB. The relationship between perceived stress and coping strategies in patients with coronary artery disease. J Korean Neuropsychiatr Assoc. 2000;39:288–96.
Mookadam F, Arthur HM. Social support and its relationship to morbidity and mortality after acute myocardial infarction: systematic overview. Arch Intern Med. 2004;164:1514–8.
Blacher RS. Paradoxical depression after heart surgery: a form of survivor syndrome. Psychoanal Q. 1978;47:267–83.
Lown B, DeSilva RA, Reich P. Psychophysiologic factors in sudden cardiac death. Am J Psychiatry. 1980;137:1325–35.
Friedman M, Thoresen CE, Gill JJ, et al. Alteration of type A behavior and reduction in cardiac recurrences in postmyocardial infarction patients. Am Heart J. 1986;108:237–48.
Richards SH, Anderson L, Jenkinson CE, et al. Psychological interventions for coronary heart disease. Cochrane Database Syst Rev. 2017;4:CD002902.
Berkman LF, Blumenthal J, Burg M, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial. JAMA. 2003;289:3106–16.
Wenger NK, Hellerstein HK. Rehabilitation of the coronary patient. 2nd ed. New York: Wiley; 1984.
McLane M, Krop H, Mehta J. Psychosexual adjustment and counseling after myocardial infarction. Ann Int Med. 1980;92:514–9.
Cay EL. Psychological aspects of cardiac rehabilitation: unsolved problems. Adv Cardiol. 1982;31:237–41.
Anderson L, Thompson DR, Oldridge N, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2016;1:CD001800.
Anderson L, Brown JP, Clark AM, et al. Patient education in the management of coronary heart disease. Cochrane Database Syst Rev. 2017;6:CD008895.
Glassman AH, Bigger JT. Cardiovascular effects of therapeutic doses of tricyclic anti-depressants: a review. Arch Gen Psychiatry. 1981;38:815–20.
McElroy SL, Keck PE, Friedman LM. Minimizing and managing antidepressant side-effects. J Clin Psychiatry. 1995;56(Suppl 2):49–55.
Beliles K, Stoudemire A. Psychopharmacologic treatment of depression in the medically ill. Psychosomatics. 1998;39:S2–S19.
Cohen H, Gibson G, Alderman M. Excess risk of myocardial infarction in patients treated with antidepressant medications: association with use of tricyclic agents. Am J Med. 2000;108:2–8.
Tata L, West J, Smith C, et al. General population based study of the impact of tricyclic and selective serotonin reuptake inhibitor antidepressants on the risk of acute myocardial infarction. Heart. 2005;91:465–71.
Morganroth J, Goin JE. Quinidine-related mortality in the short-to-medium-term treatment of ventricular arrhythmias. Meta Anal Circ. 1991;84:1977–83.
Glassman AH, Walsh BJ, Roose SP. Factors related to orthostatic hypotension associated with tricyclic antidepressants. J Clin Psychiatry. 1982;43:35–8.
Roose SP, Glassman AH, Giardina EGV. Tricyclic antidepressants in depressed patients with cardiac conduction disease. Arch Gen Psychiatry. 1987;44:273–5.
Vieweg WVR, Yazel J, Ballenger JC. Tricyclic antidepressant use in a patient with bundle branch blocks and ventricular ectopy. J Clin Psychiatry. 1984;45:353–5.
Buff DD, Brenner R, Kitane SS. Dysrhythmia associated with fluoxetine treatment in an elderly patient with cardiac disease. J Clin Psychiatry. 1991;52:174–6.
Ellison JM, Milofsky JE, Ely E. Fluoxetine-induced bradycardia and syncope in two patients. J Clin Psychiatry. 1990;51:385–6.
Feder R. Bradycardia and syncope induced by fluoxetine (letter). J Clin Psychiatry. 1991;52:139.
Fisch C. Effects of sertraline on the ECG in nonelderly and elderly patients with major depression (abstract). Biol Psychiatry. 1991;29(suppl):S353–S4.
Stoudemire A, Fogel BS. Psychopharmacology in medical patients: an update. In: Stoudemire A, Fogel BS, editors. Medical-psychiatric practice, vol. 3. Washington, DC: American Psychiatric Press; 1995.
Koh KB. Stress and psychosomatic medicine. Seoul: Ilchokak; 2011.
Roose SP, Dalack GW, Glassman AH, et al. Cardiovascular effects of bupropion in depressed patients with heart disease. Am J Psychiatry. 1991;148:512–6.
Johnson EM, Whyte E, Mulsant BH, et al. Cardiovascular changes associated with venlafaxine in the treatment of late-life depression. Am J Geriatr Psychiatry. 2006;14:796–802.
Warrington SJ. Clinical implications of the pharmacology of sertraline. Int Clin Psychopharmacol. 1991;6(Suppl 2):11–21.
Janowsky D, Gurtis G, Zisook S. Ventricular arrhythmias possibly aggravated by trazodone. Am J Psychiatry. 1983;140:796–7.
Lippman S, Bedford P, Manshadi M. Trazodone cardiotoxicity. Am J Psychiatry. 1983;140:1383.
Rowe H, Carmichael R, Lemberger L. The effect of fluoxetine on warfarin metabolism in rat and man. Life Sci. 1978;23:807–12.
Benfield P, Ward A. Fluvoxamine: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in depressive illness. Drugs. 1986;32:313–34.
Wilner KD, Lazar JD, Apseloff G. The effects of sertraline on the pharmacodynamics of warfarin in healthy volunteers (abstract). Biol Psychiatry. 1991;29(Suppl):354S–5S.
Shapiro P. Psychopharmacology in cardiac disease. In: Ferrando S, Levenson J, Robinson M, et al., editors. Handbook of psychopharmacology in the medically ill. Washington, DC: American Psychiatric Publishing; 2009.
Levenson JL, Mishra A, Bauernfeind RA. Lithium treatment of mania in a patient with recurrent ventricular tachycardia. Psychosomatics. 1986;27:594–6.
Risch SC, Groom GP, Janowsky DS. The effects of psychotropic drugs on the cardiovascular system. J Clin Psychiatry. 1982;43:16–31.
Avron J, Everitt DE, Weiss S. Increased antidepressant use in patients prescribed B-blockers. JAMA. 1986;255:357–60.
DeMuth GW, Ackerman SH. Alphamethyldopa and depression: a clinical study and review of the literature. Am J Psychiatry. 1983;140:534–8.
Croog SH, Levine S, Testa MA. The effects of antihypertensive therapy on the quality of life. New Engl J Med. 1986;314:1657–64.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Koh, K.B. (2018). Approaches to Cardiovascular Diseases. In: Stress and Somatic Symptoms. Springer, Cham. https://doi.org/10.1007/978-3-030-02783-4_20
Download citation
DOI: https://doi.org/10.1007/978-3-030-02783-4_20
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-02782-7
Online ISBN: 978-3-030-02783-4
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)