Position paper on the importance of psychosocial factors in cardiology: Update 2013
[english] Background: The rapid progress of psychosomatic research in cardiology and also the increasing impact of psychosocial issues in the clinical daily routine have prompted the Clinical Commission of the German Heart Society (DGK) to agree to an update of the first state of the art paper on th...
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| Format: | Article |
| Language: | deu |
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German Medical Science GMS Publishing House
2014-05-01
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| Series: | GMS German Medical Science |
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| Online Access: | http://www.egms.de/static/en/journals/gms/2014-12/000194.shtml |
| _version_ | 1819127316179058688 |
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| author | Ladwig, Karl-Heinz Lederbogen, Florian Albus, Christian Angermann, Christiane Borggrefe, Martin Fischer, Denise Fritzsche, Kurt Haass, Markus Jordan, Jochen Jünger, Jana Kindermann, Ingrid Köllner, Volker Kuhn, Bernhard Scherer, Martin Seyfarth, Melchior Völler, Heinz Waller, Christiane Herrmann-Lingen, Christoph |
| author_facet | Ladwig, Karl-Heinz Lederbogen, Florian Albus, Christian Angermann, Christiane Borggrefe, Martin Fischer, Denise Fritzsche, Kurt Haass, Markus Jordan, Jochen Jünger, Jana Kindermann, Ingrid Köllner, Volker Kuhn, Bernhard Scherer, Martin Seyfarth, Melchior Völler, Heinz Waller, Christiane Herrmann-Lingen, Christoph |
| author_sort | Ladwig, Karl-Heinz |
| collection | DOAJ |
| description | [english] Background: The rapid progress of psychosomatic research in cardiology and also the increasing impact of psychosocial issues in the clinical daily routine have prompted the Clinical Commission of the German Heart Society (DGK) to agree to an update of the first state of the art paper on this issue which was originally released in 2008.Methods: The circle of experts was increased, general aspects were implemented and the state of the art was updated. Particular emphasis was dedicated to coronary heart diseases (CHD), heart rhythm diseases and heart failure because to date the evidence-based clinical knowledge is most advanced in these particular areas. Differences between men and women and over the life span were considered in the recommendations as were influences of cognitive capability and the interactive and synergistic impact of classical somatic risk factors on the affective comorbidity in heart disease patients.Results: A IA recommendation (recommendation grade I and evidence grade A) was given for the need to consider psychosocial risk factors in the estimation of coronary risks as etiological and prognostic risk factors. Furthermore, for the recommendation to routinely integrate psychosocial patient management into the care of heart surgery patients because in these patients, comorbid affective disorders (e.g. depression, anxiety and post-traumatic stress disorder) are highly prevalent and often have a malignant prognosis. A IB recommendation was given for the treatment of psychosocial risk factors aiming to prevent the onset of CHD, particularly if the psychosocial risk factor is harmful in itself (e.g. depression) or constrains the treatment of the somatic risk factors. Patients with acute and chronic CHD should be offered anti-depressive medication if these patients suffer from medium to severe states of depression and in this case medication with selective reuptake inhibitors should be given. In the long-term course of treatment with implanted cardioverter defibrillators (ICDs) a subjective health technology assessment is warranted. In particular, the likelihood of affective comorbidities and the onset of psychological crises should be carefully considered.Conclusions: The present state of the art paper presents an update of current empirical evidence in psychocardiology. The paper provides evidence-based recommendations for the integration of psychosocial factors into cardiological practice and highlights areas of high priority. The evidence for estimating the efficiency for psychotherapeutic and psychopharmacological interventions has increased substantially since the first release of the policy document but is, however, still weak. There remains an urgent need to establish curricula for physician competence in psychodiagnosis, communication and referral to ensure that current psychocardiac knowledge is translated into the daily routine. |
| first_indexed | 2024-12-22T08:09:59Z |
| format | Article |
| id | doaj.art-2afd8d3bdf7f4e458673a6738b7e716c |
| institution | Directory Open Access Journal |
| issn | 1612-3174 |
| language | deu |
| last_indexed | 2024-12-22T08:09:59Z |
| publishDate | 2014-05-01 |
| publisher | German Medical Science GMS Publishing House |
| record_format | Article |
| series | GMS German Medical Science |
| spelling | doaj.art-2afd8d3bdf7f4e458673a6738b7e716c2022-12-21T18:33:03ZdeuGerman Medical Science GMS Publishing HouseGMS German Medical Science1612-31742014-05-0112Doc0910.3205/000194Position paper on the importance of psychosocial factors in cardiology: Update 2013Ladwig, Karl-Heinz0Lederbogen, Florian1Albus, Christian2Angermann, Christiane3Borggrefe, Martin4Fischer, Denise5Fritzsche, Kurt6Haass, Markus7Jordan, Jochen8Jünger, Jana9Kindermann, Ingrid10Köllner, Volker11Kuhn, Bernhard12Scherer, Martin13Seyfarth, Melchior14Völler, Heinz15Waller, Christiane16Herrmann-Lingen, Christoph17Deutsches Forschungszentrum für Gesundheit und Umwelt, Institut für Epidemiologie-2, Helmholtz-Zentrum München, Neuherberg, GermanyZentralinstitut für Seelische Gesundheit, Universität Heidelberg, Medizinische Fakultät Mannheim, GermanyKlinik und Poliklinik für Psychosomatik und Psychotherapie, Universitätsklinikum Köln, GermanyDeutsches Zentrum für Herzinsuffizienz, Universitätsklinikum Würzburg, GermanyI. Medizinische Klinik für Kardiologie, Angiologie, Pneumologie, Internistische Intensivmedizin und Hämostaseologie, Universitätsmedizin Mannheim, GermanyKlinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, GermanyAbteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Freiburg, GermanyInnere Medizin II: Kardiologie, Angiologie und Internistische Intensivmedizin, Theresienkrankenhaus und St. Hedwig-Klinik, Mannheim, GermanyHerz-, Thorax- und Rheumazentrum, Abteilung für Psychokardiologie, Kerckhoff Klinik, Bad Nauheim, GermanyKlinik für Allgemeine Innere Medizin und Psychosomatik, Universität Heidelberg, GermanyInnere Medizin III (Kardiologie/Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Homburg/Saar, GermanyMedizinische Fakultät, Universität des Saarlandes, Blieskastel, GermanyFachpraxis für Innere Medizin, Kardiologie, Angiologie und Notfallmedizin, Heidelberg, GermanyInstitut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, GermanyMedizinische Klinik 3 (Kardiologie), Helios-Klinikum Wuppertal-Herzzentrum, Universität Witten/Herdecke, Wuppertal, GermanyFachklinik für Innere Medizin, Abteilung Kardiologie, Klinik am See, Rüdersdorf, GermanyAbteilung Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, GermanyKlinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Göttingen, Germany[english] Background: The rapid progress of psychosomatic research in cardiology and also the increasing impact of psychosocial issues in the clinical daily routine have prompted the Clinical Commission of the German Heart Society (DGK) to agree to an update of the first state of the art paper on this issue which was originally released in 2008.Methods: The circle of experts was increased, general aspects were implemented and the state of the art was updated. Particular emphasis was dedicated to coronary heart diseases (CHD), heart rhythm diseases and heart failure because to date the evidence-based clinical knowledge is most advanced in these particular areas. Differences between men and women and over the life span were considered in the recommendations as were influences of cognitive capability and the interactive and synergistic impact of classical somatic risk factors on the affective comorbidity in heart disease patients.Results: A IA recommendation (recommendation grade I and evidence grade A) was given for the need to consider psychosocial risk factors in the estimation of coronary risks as etiological and prognostic risk factors. Furthermore, for the recommendation to routinely integrate psychosocial patient management into the care of heart surgery patients because in these patients, comorbid affective disorders (e.g. depression, anxiety and post-traumatic stress disorder) are highly prevalent and often have a malignant prognosis. A IB recommendation was given for the treatment of psychosocial risk factors aiming to prevent the onset of CHD, particularly if the psychosocial risk factor is harmful in itself (e.g. depression) or constrains the treatment of the somatic risk factors. Patients with acute and chronic CHD should be offered anti-depressive medication if these patients suffer from medium to severe states of depression and in this case medication with selective reuptake inhibitors should be given. In the long-term course of treatment with implanted cardioverter defibrillators (ICDs) a subjective health technology assessment is warranted. In particular, the likelihood of affective comorbidities and the onset of psychological crises should be carefully considered.Conclusions: The present state of the art paper presents an update of current empirical evidence in psychocardiology. The paper provides evidence-based recommendations for the integration of psychosocial factors into cardiological practice and highlights areas of high priority. The evidence for estimating the efficiency for psychotherapeutic and psychopharmacological interventions has increased substantially since the first release of the policy document but is, however, still weak. There remains an urgent need to establish curricula for physician competence in psychodiagnosis, communication and referral to ensure that current psychocardiac knowledge is translated into the daily routine.http://www.egms.de/static/en/journals/gms/2014-12/000194.shtmldepressionanxietypost-traumatic stress disorderpsychotherapypsychopharmacology |
| spellingShingle | Ladwig, Karl-Heinz Lederbogen, Florian Albus, Christian Angermann, Christiane Borggrefe, Martin Fischer, Denise Fritzsche, Kurt Haass, Markus Jordan, Jochen Jünger, Jana Kindermann, Ingrid Köllner, Volker Kuhn, Bernhard Scherer, Martin Seyfarth, Melchior Völler, Heinz Waller, Christiane Herrmann-Lingen, Christoph Position paper on the importance of psychosocial factors in cardiology: Update 2013 GMS German Medical Science depression anxiety post-traumatic stress disorder psychotherapy psychopharmacology |
| title | Position paper on the importance of psychosocial factors in cardiology: Update 2013 |
| title_full | Position paper on the importance of psychosocial factors in cardiology: Update 2013 |
| title_fullStr | Position paper on the importance of psychosocial factors in cardiology: Update 2013 |
| title_full_unstemmed | Position paper on the importance of psychosocial factors in cardiology: Update 2013 |
| title_short | Position paper on the importance of psychosocial factors in cardiology: Update 2013 |
| title_sort | position paper on the importance of psychosocial factors in cardiology update 2013 |
| topic | depression anxiety post-traumatic stress disorder psychotherapy psychopharmacology |
| url | http://www.egms.de/static/en/journals/gms/2014-12/000194.shtml |
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