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Aktuelle Kardiologie 2015; 4(06): 362-365
DOI: 10.1055/s-0041-108191
Übersichtsarbeit
Georg Thieme Verlag KG Stuttgart · New York

Psychosoziale Risikofaktoren des akuten Myokardinfarkts

Psychosocial Risk Factors for Myocardial Infarction
K.-H. Ladwig
1   Institut für Epidemiologie, Helmholtz Zentrum München – Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg
2   Klinik und Polyklinik für Psychosomatische Medizin und Psychotherapie, Klinikum rechts der Isar, Technische Universität München
,
K. Lukaschek
1   Institut für Epidemiologie, Helmholtz Zentrum München – Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg
3   Klinik für Psychosomatik und Psychotherapie, Universitätsklinikum Gießen
,
B. Kuhn
4   Kardiologische Gemeinschaftspraxis, Facharztzentrum Nord, Heidelberg
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
14. Dezember 2015 (online)

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Zusammenfassung

Ein Meilenstein der Psychokardiologie ist der Nachweis von psychosozialen Risikofaktoren für die Vorhersage kardiovaskulärer Ereignisse, unabhängig von und nach Kontrolle der klassischen somatischen Risikofaktoren. Gemäß der zeitlichen Dauer der Exposition werden akute, episodische und chronische Stressfaktoren unterschieden. Zu den akuten Faktoren zählen Trauerreaktionen und Episoden von destruktivem Ärger; zu den episodischen Faktoren zählen ein zerstörerisches Streitklima in Familie und am Arbeitsplatz sowie eine depressive Stimmungslage. Zu den chronischen Faktoren zählen stabile Persönlichkeitseigenschaften wie das Typ-D-Verhaltensmuster. Eine psychosomatische Phänotypisierung sollte Bestandteil einer ausführlichen kardiologischen Anamnese sein.

Abstract

A milestone in psychocardiology is the proof of psychosocial risk factors for predicting cardiovascular events, independent of and after adjustment for the classical somatic risk factors. According to the temporal duration of exposure, factors are divided into acute, episodic and chronic stress factors. A prolonged grief reaction and outbursts of severe anger are among the acute conditions while a destructive family climate and work environment count among episodic factors as does sustained depressed mood. Stable personality traits like the type-D-behavior pattern are among chronic conditions which act as CHD risk factors. A psychosomatic phenotyping should be part of the cardiologic assessment of the patientʼs history.

Schlüsselwörter

psychosoziale Risikofaktoren - Vorhersage - koronare Herzerkrankung - Expositionszeit

Key words

psychosocial risk factors - prediction - coronary heart disease - exposure time
 

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