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Significance of psychosocial factors in cardiology: update 2018: Position paper of the German Cardiac Society
Open accessAbstract
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.
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Metadata
- Authors
- Albus, C., Waller, C., Fritzsche, K., Gunold, H., Haass, M., Hamann, B., Kindermann, I., Köllner, V., Leithäuser, B., Marx, N., Meesmann, M., Michal, M., Ronel, J., Scherer, M., Schrader, V., Schwaab, B., Weber, C. S., & Herrmann-Lingen, C.
- Affiliations
- University Hospital Cologne (DE)
- Nuremberg Hospital (DE)
- University Medical Center Freiburg (DE)
- University Hospital Leipzig (DE)
- Kerckhoff Klinik (DE)
- Universitätsklinikum des Saarlandes (DE)
- Universitätsklinikum Aachen (DE)
- Stiftung Juliusspital (DE)
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- Klinik Barmelweid (CH)
- University Medical Center Hamburg-Eppendorf (DE)
- Corresponding author
- Albus, Christian
- ORCID
- Venue
- Clinical Research in Cardiology
- Published
- 2019-05-10
- Volume
- 108
- Issue
- 11
- Pages
- 1175-1196
- ISSN
- 1861-0684 (ISSN-L)
- 1861-0692
- OpenAlex
- W2944055338
- Cited by
- 178
- References
- 188
- Citations by year
- 2026: 10 · 2025: 33 · 2024: 28 · 2023: 34 · 2022: 33 · 2021: 20 · 2020: 15 · 2019: 1
- FWCI
- 12.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Clinical Research in Cardiology (publishedVersion)
- PubMed (publishedVersion)
- GoeScholar The Publication Server of the Georg-August-Universität Göttingen (Georg-August-Universität Göttingen) (submittedVersion, cc-by)
- RWTH Publications (RWTH Aachen) (submittedVersion)
- Funders
- Universität zu Köln
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- psychosocial factors, cardiovascular disease, socioeconomic status, chronic stress, depression, anxiety, social support, coronary artery disease, chronic heart failure, hypertension, cardiac arrhythmias, psychosocial interventions, psychotherapy, psychotropic drugs, motivational counseling, stress management, relaxation training, patient education, physical activity, prognosis, clinical guidelines
- MeSH terms
- Attitude of Health Personnel, Mental Disorders, Cardiology, Cardiovascular Diseases, Germany, Humans, Societies, Medical, Socioeconomic Factors
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