Psychological Effects Associated With Coronary Artery Disease

According to a January, 2002 article in the Annual Review of Psychology, there is disagreement between some in the medical community and some in the psychological and behavioral communities about whether there is any connection at all between disease and psychological factors. The Annual Review of Psychology article quotes a 1985 editorial from the New England Journal of Medicine to show one viewpoint: "In short, the literature contains few scientifically sound studies of the relation, if there is one, between mental state and disease ..." The authors of the Psychology Review article disagree and state that research in the behavioral sciences and medicine suggest a direct role for psychological and social factors in organic coronary artery disease (CAD). Five possible variables identified as risk factors include depression, stress, hostility, social support and socioeconomic status.

• Scientists disagree over the psychology effects of coronary artery disease.

Depression

• According to research presented at the American College of Neuropsychopharmacology (ACNP) annual meeting, depression can nearly triple the risk of death after a heart attack. Researchers followed 360 post-heart attack patients for over six years and determined that those who remained depressed for longer than six months were more than twice as likely to die. Screening of heart patients and treating depression when found is recommended.

Stress

• While the general public has become more aware of lifestyle risk factors such as stress in relation to CAD, research shows that while stress is unavoidable, it is the individual's response to stress that varies. A new Type D personality has been identified. Type D personality stands for "distressed," or tending to experience worry, irritability and pessimism as well as a tendency to feel insecure around other people. The personality study showed a five to eight-fold increased risk of heart attack for Type D personalities.

Hostility

• The stereotype of the angry, aggressive individual being stricken by a heart attack in the middle of a tirade is a common theme in popular culture. This is not entirely without foundation, according to the research cited above. Hostility is only one factor in the Type D personality, however, and is possibly related to their tendency to blow any negative event out of proportion.

Social Support

• According to the Mayo Clinic, having a social support network has many health benefits. Social support networks are simply your friends and family; people who care about you and provide a secure sense of belonging. The Type D personality mentioned above has difficulty developing a social support network because of her tendency to irritability and insecurity around other people.

Socioeconomic Status

• According to a Duke University study, low-income CAD individuals were more than twice as likely to die as those with higher incomes. Part of this discrepancy is believed to be due to low-income patients' inability to pay for their medications. Poverty may also contribute to depression and social isolation.