Psychocardiology
Psychocardiology is a special discipline in human medicine that deals with the mutual relationship between psychological factors and heart diseases. It describes the interaction between heart and psyche, the interface between psychosomatics and cardiology .
Recent epidemiological studies show that regardless of the known risk factors such as smoking, diabetes mellitus , high blood pressure or lipid metabolism disorders, there is a connection between certain mental illnesses on the one hand and certain heart diseases .
Compared to mentally healthy people with otherwise the same cardiovascular risk profile, people suffering from depression have a significantly higher risk of constrictions in the coronary arteries ( coronary heart disease , CHD) or a heart attack . Depression also has a negative impact on the course of existing cardiovascular diseases . It could also be shown that a chronically increased level of tension in men is a risk factor for the occurrence of a certain cardiac arrhythmia ( atrial fibrillation ). Anxiety disorders increase the overall mortality rate in men and women. The first biological explanatory models for these findings are available and relate to changes in hormone levels in mental illnesses (especially cortisol and norepinephrine ); It is also clear, however, that depressed people can care less about their heart health than those who are mentally healthy.
It follows that depression and anxiety disorders also act as risk factors for heart disease such as B. the CHD are treated. In connection with depression, coronary heart disease in particular has to be regarded more than ever as a psychosomatic illness, i.e. as an illness in which psychological and physical factors play a role in its development and progression.
Psychosocial Components
In many organic diseases, psychological factors influence the development, intensity and maintenance of the symptoms to varying degrees. There are numerous chronic psychosocial factors that are believed to be contributory factors in cardiovascular disease. Psychosocial components can negatively affect this.
Psychosocial risk factors according to Albus
- Long-term depressive symptoms and depressive disorders
- Long-term fear
- Post-traumatic stress disorder
- lack of social support
- chronic loneliness
- social isolation
- Type-D personality
therapy
This has consequences for the therapy. For example, in the overall treatment plan for patients with coronary artery disease and depressive disorder, the following points must be taken into account from a psychocardiological perspective:
- the survey of the medical history must include the questioning of mental health problems,
- a current psychological finding is to be collected,
- psycho-educational measures, d. H. Informing those affected about the psychologically relevant factors,
- Training in coping with stress, activation of psychological protective factors, psychological aspects of weight reduction and much more,
- the optimization of the drug treatment also includes antidepressant medication in the given case,
- Nutritional advice (e.g. regarding fats),
- Sports therapy (with monitor monitoring if necessary) with detailed information about optimal training loads, learning about endurance sports,
- Weight reduction
- Optimization of blood pressure and, if necessary, blood sugar setting,
- physical therapy including physiotherapy,
- Individual relaxation training (selection from a variety of methods possible),
- Individual or group psychotherapy depending on the indication.
Such an overall treatment plan can be either outpatient or as part of inpatient treatment, e.g. B. a cardiological follow-up treatment to be established. According to the current state of research, a therapy that consists of cooperation between cardiologist, family doctor and psychotherapist can work best. It is very important that this cooperation works, as physical and psychological factors can influence each other. Thus, a one-sided treatment would not be goal-oriented.
Inpatient treatment
Heart disease and accompanying physical symptoms and psychological impairments can be so pronounced that outpatient treatments are insufficient or cannot be sought out regularly. “Inpatient psychocardiological treatment, which is necessary in severe or acute cases, has so far only rarely been offered in Germany,” says a press release from the University Medical Center Göttingen. One of the first psychocardiological wards in Germany was set up in the Heart Center of the University Medical Center Göttingen in 2009.
See also
Web links
- Heart and brain in close connection Pharmaceutical newspaper online. Published by the ABDA - Federal Association of German Pharmacists' Associations , Berlin
- What is psychocardiology? Institute of Psychocardiology
- How the soul makes the heart sick . Stern online report on psychocardiology, November 15, 2008
- www.psychokardiologie.org Psychocardiology information portal
Individual evidence
- ↑ novego.de ( Memento of the original from June 18, 2012 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ novego.de ( Memento of the original from September 20, 2012 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Treating heart and soul holistically Press release of the University Medical Center Göttingen, December 17, 2009.
