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Psychosocial Management of Patients with Heart Disease

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The Massachusetts General Hospital Handbook of Behavioral Medicine

Part of the book series: Current Clinical Psychiatry ((CCPSY))

Abstract

Cardiovascular disease (CVD) is the leading cause of death in the United States. Across different manifestations of CVD, depression and anxiety disorders are common, under-recognized, and persistent. Furthermore, there is increasingly clear evidence that these psychiatric conditions are independent predictors of adverse cardiac events and mortality. Practitioners of behavioral medicine can play a vital role in managing patients with CVD by identifying common coping challenges and assessing patients at risk for mood and anxiety disorders. Though selective serotonin reuptake inhibitors (SSRIs) are safe and effective for treating anxiety disorders and depression among cardiac patients, there are several effective, well-tolerated, and evidence-based psychotherapeutic approaches. Cognitive behavioral therapy (CBT) and problem-solving therapy (PST) are the best-studied interventions and may be useful as stand-alone interventions or in the context of a collaborative medical-mental health care team approach. Several emerging therapies may also be useful, including mindfulness-based treatments and acceptance and commitment therapy (ACT). In addition, technological intervention delivery and telehealth programs can play important roles in reaching medically ill populations. Patients with comorbid CVD and anxiety or depression can experience relief from psychological symptoms with skillful application of evidence-based therapies and a team approach to care management.

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Abbreviations

ACS:

Acute coronary syndrome

ACT:

Acceptance and commitment therapy

CABG:

Coronary artery bypass graft

CAD:

Coronary artery disease

CBT:

Cognitive behavioral therapy

CVD:

Cardiovascular disease

GAD:

Generalized anxiety disorder

HF:

Heart failure

MBSR:

Mindfulness-based stress reduction

MDD:

Major depressive disorder

MI:

Myocardial infarction

PD:

Panic disorder

PP:

Positive psychology

PST:

Problem-solving therapy

PTSD:

Post-traumatic stress disorder

QoL:

Quality of life

SSRI:

Selective serotonin reuptake inhibitor

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Authors and Affiliations

  1. Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Rachel A. Millstein Ph.D., M.H.S.

  2. Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Warren 1220/Blake 11, Boston, MA, 02114, USA

    Jeff C. Huffman M.D.

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  1. Rachel A. Millstein Ph.D., M.H.S.
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  2. Jeff C. Huffman M.D.
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Correspondence to Jeff C. Huffman M.D. .

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Editors and Affiliations

  1. Department of Psychiatry Behavioral Medicine Service, Massachusetts General Hospital, Boston, Massachusetts, USA

    Ana-Maria Vranceanu

  2. Dept. of Psychiatric Oncology & Behavior, Massachusetts General Hospital Cancer Ce, Boston, Massachusetts, USA

    Joseph A. Greer

  3. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA

    Steven A. Safren

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Millstein, R.A., Huffman, J.C. (2017). Psychosocial Management of Patients with Heart Disease. In: Vranceanu, AM., Greer, J., Safren, S. (eds) The Massachusetts General Hospital Handbook of Behavioral Medicine. Current Clinical Psychiatry. Humana Press, Cham. https://doi.org/10.1007/978-3-319-29294-6_10

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  • DOI: https://doi.org/10.1007/978-3-319-29294-6_10

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