Download PDF
Psychother Psychosom Med Psychol 2019; 69(06): 237-252
DOI: 10.1055/a-0870-1420
CME-Fortbildung
© Georg Thieme Verlag KG Stuttgart · New York

Psychokardiologie – aktuelle Leitlinien und klinische Realität

Christoph Herrmann-Lingen
Further Information

Publication History

Publication Date:
06 June 2019 (online)

Also available at
   Permissions and Reprints

Abstract

In the last decades, psychocardiological knowledge has contributed a lot to the understanding of psychosocial factors involved in the pathogenesis, course, and treatment of cardiovascular diseases. Therefore, psychological, social, and behavioral factors should be detected and addressed early on in order to prevent cardiovascular disease and/or its progression. On the other hand, cardiovascular disease is an important stressor which can lead to psychological comorbidities and thus deteriorate prognosis and quality of life. During therapy a clear, consistent, and empathic communication between professionals and patients is of importance. Up to now there is not much evidence as to the effectiveness of psychotherapeutic interventions or antidepressant medication for cardiac patients with mental comorbidities. Beyond psychosomatic basic care, combined with physical activity, severely ill patients may require multimodal inpatient care in specialized psychosomatic or psychocardiological units and continuous support with lifestyle change.

Schlüsselwörter

Diagnose - Psychosomatik - Psychotherapie - pharmakologische Behandlung - psychologische Komorbidität

Key words

Diagnosis - psychosomatics - psychotherapy - pharmacological treatment - psychological comorbidity
 

  • Literatur

  • 1 Joachim H. Papyros Ebers. Das älteste Buch über Heilkunde. Aus dem Aegyptischen zum ersten Mal vollständig übersetzt. Band 2. Berlin: Reimer; 1890
    Google Scholar
  • 2 Piepoli MF, Hoes AW, Agewall S. et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37: 2315-2381
    CrossrefPubMedGoogle Scholar
  • 3 Lichtman JH, Froelicher ES. Blumenthal et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: Systematic review and recommendations: A scientific statement from the American Heart Asociation. Circulation 2014; 129: 1350-1369
    CrossrefPubMedGoogle Scholar
  • 4 Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale Versorgungs Leitlinie Chronische KHK – Langfassung, 4. Auflage 2016. Im Internet: https://www.leitlinien.de/mdb/downloads/nvl/khk/khk-4aufl-vers1-kurz.pdf Stand: 03.02.2018
    PubMed
  • 5 Albus C, Waller C, Fritzsche K. et al. Bedeutung von psychosozialen Faktoren in der Kardiologie. Update 2018. Kardiologe 2018; 12: 312-331
    PubMedGoogle Scholar
  • 6 Ponikowski P, Voors AA, Anker SD. et al. 2016; ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. The Task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2016: 2315-2381
    PubMedGoogle Scholar
  • 7 Braunschweig F, Boriani G, Bauer A. et al. Management of patients receiving implantable cardiac defibrillator shocks: recommendations for acute and long-term patient management. Europace 2010; 12: 1673-1690
    CrossrefPubMedGoogle Scholar
  • 8 Ghadri JR, Wittstein IS, Prasad A. et al. International Expert Consensus Document on Takotsubo Syndrome (Part I): Clinical characteristics, diagnostic criteria, and pathophysiology. Eur Heart J 2018; 39: 2032-2046
    CrossrefPubMedGoogle Scholar
  • 9 Albus C. Risikoverhalten. In Herrmann-Lingen C, Albus C, Titscher G. Psychokardiologie – ein Praxisleitfaden für Ärzte und Psychologen. Köln: Deutscher Ärzte-Verlag. 2014: 78-86
    Google Scholar
  • 10 Herrmann-Lingen C, alʼAbsi M. Exploring the association of hypertension with risk for depression: Evidence for tamed neurobehavioral arousal versus central emotional dysregulation. Psychosom Med 2018; 80: 504-507
    CrossrefPubMedGoogle Scholar
  • 11 Persu A, Petit G, Georges C. et al. Hypertension, a posttraumatic stress disorder? Time to widen our perspective. Hypertension 2018; 71: 811-812
    CrossrefPubMedGoogle Scholar
  • 12 Mann SJ. Psychosomatic research in hypertension: the lack of impact of decades of research and new directions to consider. J Clin Hypertens (Greenwich) 2012; 14: 657-664
    CrossrefPubMedGoogle Scholar
  • 13 Dantzer R. Cytokine, sickness behavior, and depression. Immunol Allergy Clin North Am 2009; 29: 247-264
    CrossrefPubMedGoogle Scholar
  • 14 Spitzer C, Meyer T, Herrmann-Lingen C. Komplexe Traumatisierungen und körperliche Gesundheit. Zur Assoziation von Kindesmisshandlungen und koronarer Herzkrankheit. Psychotherapeut 2016; 61: 191-196
    PubMedGoogle Scholar
  • 15 Waller C. (Trans-)Generationale Weitergabe früher Traumatisierung auf das kardiovaskuläre System. Psychotherapeut 2017; 62: 507-512
    CrossrefPubMedGoogle Scholar
  • 16 Herrmann-Lingen C. Biopsychosoziale Faktoren in Genese und Manifestation der Koronaren Herzkrankheit. Z Psychosom Med Psychother 2000; 46: 315-330
    PubMedGoogle Scholar
  • 17 Meyer T, Herrmann-Lingen C. Natriuretic peptides in anxiety and panic disorder. Vitam Horm 2017; 103: 131-146
    CrossrefPubMedGoogle Scholar
  • 18 Fangauf SV, Belnap BH, Meyer T. et al. Associations of NTproBNP and parameters of mental health in depressed coronary artery disease patients. Psychoneuroendocrinology 2018; 96: 188-194
    CrossrefPubMedGoogle Scholar
  • 19 Lespérance F, Frasure-Smith N, Koszycki D. et al. Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: the Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial. JAMA 2007; 297: 367-379
    CrossrefPubMedGoogle Scholar
  • 20 Berkman LF, Blumenthal J, Burg M. et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA 2003; 289: 3106-3116
    CrossrefPubMedGoogle Scholar
  • 21 Herrmann-Lingen C, Beutel ME, Bosbach A. et al. A stepwise psychotherapy intervention for reducing risk in coronary artery disease (SPIRR‑CAD): Results of an observer-blinded, multicenter, randomized trial in depressed patients with coronary artery disease. Psychosom Med 2016; 78: 704-715
    CrossrefPubMedGoogle Scholar
  • 22 Jeyanantham K, Kotecha D, Thanki D. Effects of cognitive behavioural therapy for depression in heart failure patients: a systematic review and meta-analysis. Heart Fail Rev 2017; 22: 731-741
    CrossrefPubMedGoogle Scholar
  • 23 DGPPN BÄKKBV et al.S3-Leitlinie/Nationale Versorgungs-Leitlinie Unipolare Depression – Langfassung, 2. Auflage. Version 5. 2015. Im Internet: https https://www.awmf.org/uploads/tx_szleitlinien/nvl-005l_S3_Unipolare_Depression_2017-05.pdf Stand: 14.08.2018
    PubMed
  • 24 Glassman AH, OʼConnor CM, Califf RM. et al. Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA 2002; 288: 701-709
    CrossrefPubMedGoogle Scholar
  • 25 Kim JM, Bae KY, Stewart R. et al. Escitalopram treatment for depressive disorder following acute coronary syndrome: a 24-week double-blind, placebo-controlled trial. J Clin Psychiatry 2015; 76: 62-68
    CrossrefPubMedGoogle Scholar
  • 26 OʼConnor CM, Jiang W, Kuchibhatla M. et al. Safety and efficacy of sertraline for depression in patients with heart failure: results of the SADHART‑CHF (Sertraline Against Depression and Heart Disease in Chronic Heart Failure) trial. J Am Coll Cardiol 2010; 56: 692-699
    CrossrefPubMedGoogle Scholar
  • 27 Angermann CE, Gelbrich G, Störk S. et al. Effect of escitalopram on all-cause mortality and hospitalization in patients with heart failure and depression: The MOOD‑HF Randomized Clinical Trial. JAMA 2016; 315: 2683-2693
    CrossrefPubMedGoogle Scholar
  • 28 Kim JM, Stewart R, Lee YS. et al. Effect of escitalopram vs. placebo treatment for depression on long-term cardiac outcomes in patients with acute coronary syndrome: A randomized clinical trial. JAMA 2018; 320: 350-358
    CrossrefPubMedGoogle Scholar
  • 29 Olewinski M, Paschke AM, Mohebbi A. et al. An integrative psychosomatic Approach to the Treatment of Patients with cardiovascular Diseases: Concepts and Experiences of a dedicated Psychocardiology Ward at the University of Göttingen Medical Center. In Baune BT, Tully PJ. (eds.) Cardiovascular Diseases and Depression – Treatment and Prevention in Psychocardiology. Cham: Springer; Switzerland: 2016: 493-507
    Google Scholar
  • 30 Tully PJ, Baumeister H. Collaborative care for comorbid depression and coronary heart disease: a systematic review and meta-analysis of randomized controlled trials. BMJ Open 2015; 5: e009128
    CrossrefPubMedGoogle Scholar
  • 31 Meyer T, Belnap BH, Herrmann-Lingen C. et al. Benefits of collaborative care for post-CABG depression are not related to adjustments in antidepressant pharmacotherapy. J Psychosom Res 2014; 76: 28-33
    CrossrefPubMedGoogle Scholar
  • 32 Katon WJ, Lin EH, Von Korff M. et al. Collaborative care for patients with depression and chronic illnesses. N Engl J Med 2010; 363: 2611-2620
    CrossrefPubMedGoogle Scholar
  • 33 Rossom RC, Solberg LI, Magnan S. et al. Impact of a national collaborative care initiative for patients with depression and diabetes or cardiovascular disease. Gen Hosp Psychiatry 2017; 44: 77-85
    CrossrefPubMedGoogle Scholar
  • 34 Bosselmann L, Herbeck Belnap B, Fangauf SV. et al. Durchführbarkeit und Wirksamkeit eines kollaborativen Behandlungsansatzes in der Sekundärprävention der Koronaren Herzkrankheit. Z Psychosom Med Psychother 2018; 64: 44-45 (abstract)
    PubMedGoogle Scholar
  • 35 Kohrs M. Die Narzisstische Persönlichkeitsstörung im Spannungsfeld unterschiedlicher Theorien und Behandlungsansätze. In Boll-Klatt A, Kohrs M. Praxis der psychodynamischen Psychotherapie. 2. Aufl. Stuttgart: Schattauer; 2018: 516-542
    Google Scholar