Stress, Coping, and Cardiovascular Disease

By Philip M. McCabe; Neil Schneiderman et al. | Go to book overview

tween psychosocial variables and mortality in an experimental context. That is, it is necessary to determine whether changing psychosocial factors will influence mortality. The medical literature is full of examples in which interventions designed to alter established prognostic factors had an unexpected negative or null impact on prognosis (e.g. The Cardiac Arrhythmia Suppression Trial [CAST] Investigators, 1989). Of course, research examining the impact of changing psychosocial factors assumes that we know how to change depression and social support in a post-MI population. Currently, this is far from the case. Although there are well-established medical and psychological treatments for depression, no research has yet evaluated the efficacy and safety of these approaches following a heart attack. In addition, while work is ongoing in the context of the National Heart, Lung, and Blood Institute sponsored Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) trial, interventions for improving social support remain to be designed and evaluated.


ACKNOWLEDGMENTS

This study was supported by grants from the Joint Research Grant Program in Mental Health of the Fonds de la recherche en santé du Québec (FRSQ) and the Quebec Council of Social Research (CQRS), the Medical Research Council (MRC) of Canada, and the Montreal Heart Institute Research Fund.

The contributions of Drs. Duncan Stewart and Jean-Lucien Rouleau (who served on the committee to judge causes of death), and of Nicole Gélinas, Annick Girard, Danielle Beaudoin, RN, Louise Girard, Denise Pagé, RN, and Doris Morissette, RN (who participated in data collection and coding), are gratefully acknowledged.


REFERENCES

Ahern D. K., Gorkin L., Anderson J. L., Tierney C., Hallstrom A., Ewart C., Capone R. J.' Schron, E., Kornfeld, D., Herd, J. A., Richardson, D. W, & Follick M. J. ( 1990). "Biobehavioral variables and mortality or cardiac arrest in the Cardiac Arrhythmia Pilot Study" (CAPS). The American Journal of Cardiology, 66, 59-62.

American Psychiatric Association, "Committee on Nomenclature and Statistics". ( 1987). Diagnostic and statistical manual of mental disorders, revised ( 3rd ed.) Washington, DC: American Psychiatric Association.

Arora R. C., & Meltzer H. Y. ( 1989). "Increased serotonin, (5-HT2) receptor binding as measured by 3H-lysergic acid diethylamide (3H-LSD) in the blood platelets of depressed patients". Life Sciences, 44, 725-734.

Avorn J., Everitt D. E., & Weiss S. ( 1986) "Increased antidepressant use in patients prescribed ß-blockers". Journal of the American Medical Association, 66, 59-62.

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