Universität zu Köln

Albus, Christian, Waller, Christiane, Fritzsche, Kurt, Gunold, Hilka, Haass, Markus, Hamann, Bettina, Kindermann, Ingrid, Koellner, Volker, Leithaeuser, Boris, Marx, Nikolaus, Meesmann, Malte, Michal, Matthias, Ronel, Joram, Scherer, Martin, Schrader, Volker, Schwaab, Bernhard, Weber, Cora Stefanie and Herrmann-Lingen, Christoph (2019). Significance of psychosocial factors in cardiology: update 2018 Position paper of the German Cardiac Society. Clin. Res. Cardiol., 108 (11). S. 1175 - 1197. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Background Psychosocial factors in cardiovascular diseases are increasingly acknowledged by patients, health care providers and payer organizations. Due to the rapidly increasing body of evidence, the German Cardiac Society has commissioned an update of its 2013 position paper on this topic. The German version was published in 2018 and the current manuscript is an extended translation of the original version. Methods This position paper provides a synopsis of the state of knowledge regarding psychosocial factors in the most relevant cardiovascular diseases and gives recommendations with respect to their consideration in clinical practice. Results Psychosocial factors such as low socioeconomic status, acute and chronic stress, depression, anxiety and low social support are associated with an unfavorable prognosis. Psychosocial problems and mental comorbidities should be assessed routinely to initiate targeted diagnostics and treatment. For all patients, treatment should consider age and gender differences as well as individual patient preferences. Multimodal treatment concepts should comprise education, physical exercise, motivational counseling and relaxation training or stress management. In cases of mental comorbidities, brief psychosocial interventions by primary care providers or cardiologists, regular psychotherapy and/or medications should be offered. While these interventions have positive effects on psychological symptoms, robust evidence for possible effects on cardiac outcomes is still lacking. Conclusions For coronary heart disease, chronic heart failure, arterial hypertension, and some arrhythmias, there is robust evidence supporting the relevance of psychosocial factors, pointing to a need for considering them in cardiological care. However, there are still shortcomings in implementing psychosocial treatment, and prognostic effects of psychotherapy and psychotropic drugs remain uncertain. There is a need for enhanced provider education and more treatment trials.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Albus, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Waller, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Fritzsche, Kurt UNSPECIFIED UNSPECIFIED UNSPECIFIED Gunold, Hilka UNSPECIFIED UNSPECIFIED UNSPECIFIED Haass, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamann, Bettina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kindermann, Ingrid UNSPECIFIED UNSPECIFIED UNSPECIFIED Koellner, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Leithaeuser, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Marx, Nikolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Meesmann, Malte UNSPECIFIED UNSPECIFIED UNSPECIFIED Michal, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Ronel, Joram UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherer, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Schrader, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwaab, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Cora Stefanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Herrmann-Lingen, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-129712
DOI:	10.1007/s00392-019-01488-w
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	108
Number:	11
Page Range:	S. 1175 - 1197
Date:	2019
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CORONARY-HEART-DISEASE; QUALITY-OF-LIFE; COGNITIVE-BEHAVIORAL THERAPY; IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS; POSTTRAUMATIC-STRESS-DISORDER; ACUTE MYOCARDIAL-INFARCTION; RISK-FACTORS; SCIENTIFIC STATEMENT; ARTERY-DISEASE; ATRIAL-FIBRILLATION Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12971