Psychiatria pre prax 1/2004

Psychosomatic and psychosocial issues of cardiovascular diseases

It is well known, that depressive symptomatology and anxious states are highly prevalent in general internal and cardiologic practice. They increase both, the risk of the development of diseases and its recurrence as well. Antidepressive treatment may improve the quality of life of these patients. Selective serotonin reuptake inhibitors (SSRI), besides the effectiveness in the therapy of major depressions in specialized psychiatric practice have broader indications to influence somatization disorders experienced in hidden depressions. Improvement of the quality of live by this therapy is evident, however it does not exist sufficient evidence that antidepressive treatment decreases morbidity and mortality of patients after myocardial infarction. In spite of it, pharmacodynamics of SSRI provide plausible phenomenological explanation for the expected favorable influence in terms of primary and secondary prevention of coronary heart disease. Clinicians should be aware that these patients evidently suffer, seek help and finally, when suspecting the doctor to depreciate their complaints look for alternative medical practices leading sometimes to harmful consequences.

Keywords: coronary heart diseases, depression, anxiety, antidepressant therapies.