Revista Colombiana de Psiquiatría
Print version ISSN 0034-7450
Recent studies provide clear evidence that psychosocial factors contribute significantly to the pathogenesis and expression of coronary disease. This evidence is composed largely of data relating cardiac disease risk to 5 specific psychosocial domains: (1) depression, (2) anxiety, (3) personality factors and character traits, (4) social isolation and (5) chronic and acute life stress. Pathophysiological mechanisms underlying the relationship between these entities can be due to a excessive sympathetic nervous system activation, endothelial dysfunction, immunological and hematological abnormalities. In this review, we examine new epidemiologic evidence for the association between psychosocial risk factors and cardiac disease, identify pathologic mechanisms that may be responsible, and describe a paradigm for studying positive psychologic factors that may act as a buffer; also we review new approaches to improve the delivery of behavioral services and patient compliance. These are part of an emerging field of behavioral cardiology, which is based on the understanding that psychosocial and behavioral risk factors for cardiac disease, are not only highly interrelated, but also require team work between the cardiologist and the psychiatrist.
Keywords : Depression; anxiety; stress; cardiovascular disease.