Psychological distress in cardiovascular disease

Distress affects both quality of life as well as risk for morbidity.  Trait anxiety has been identified as producing poorer quality of life for  cardiac patients.

Cardiac invalidism is a condition where fear and anxiety over a heart attack leads individuals to refrain from participating in everyday activities that they actually could do. Taking on something of a sick role.

Initial response following cardiac arrest usually involves anxiety and may involve panic.  Intrusive thoughts and depression may also follow, where incidence for depression three time higher for cardiac patients, and it is double for women over men. Older cardiac patients too are more likely than younger ones to experience depression and difficulties with everyday activities.

Depressed patients have higher heart rates and don't adjust their heart rate in response to blood pressure changes.

Helping people cope with cardiovascular disease

Rehabilitation programmes tend to be holistic and may involve psychotherapy along with monitoring of physical condition, education for medication and diet, exercise, stress reduction and social support. One challenge is that drop out rates are high for rehabilitation programmes, but success

Anger is also an important factor regarding CHD, where experiencing intense anger  can lead to a fatal heart attack. To avoid this, they are taught to monitor their emotions and learn cognitive reappraisal and restructuring.

    Negative Mood and Coronary Heart Disease (CHD)

Aside from compromised immune function, depression has also been associated with impaired cardiovascular function and mortality after diagnosis (See Poole et al. 2010).

Pratt et al (1996) have found that people diagnosed with major depression are 4.5 times as likely to suffer a heart attack. Other studies suggest similar but smaller risks.

Penninx et al. (1998) found that newly depressed older men were more likely to suffer from heart disease and die from it, in contrast to chronically depressed older men.

People suffereing from Major vs minor depression more likely hospitalized after five years (Sullivan, LaCroix, Spertus Hecht & Russo, 2003)

Poole et al. report that these finding indicate a bi-directional causality for depression and heart disease.

“Physiological mechanisms by which depression increases risk of mortality for cardiac patients are not entirely clear (Grippo & Johnson, 2002)” (Poole et al., 2010, p. 214), and that causes may be related to autonomic nervous system or inflammation.

Personality  & CHD

Eysenk and colleagues also carried out a study on concentration camp survivors and found that they were more likely to die from cancer or CHD.

They also found that Type-1 personality (also referred to as Type C) was more predictive of contracting cancer.Poole et al. suggest that the diathesis-stress model is likely at play here where personality type, genetic background and stress exposure interact in the manifestation and prognosis of cancer.

Wadee et al. (2000) report on Personality factors, stress and immunity showng that students who experience anxiety are more likely to show immunocompromise.