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Psychosocial assessment and psychological interventions following a cardiac event
  1. David R Thompson1,
  2. Susanne S Pedersen2
  1. 1School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
  2. 2Department of Cardiology, Odense University Hospital, Odense, Denmark
  1. Correspondence to Professor David R Thompson, School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK; David.Thompson{at}

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Learning objectives

  • Define what a psychological intervention is.

  • Describe key psychosocial factors for people with cardiovascular disease and their impact on health and well-being.

  • Identify instruments used to screen people for psychosocial factors.


Despite growing recognition of the impact of psychosocial factors on cardiovascular disease (CVD), as exemplified in recent guidelines from the European Society of Cardiology1 and a Scientific Statement from the American Heart Association,2 they do not receive the same degree of attention as other aspects of preventive cardiology, such as physical activity. Yet, psychosocial factors, such as depression and anxiety, adversely influence adherence to medication and act as barriers to behaviour change and also adversely affect the health and well-being of patients, their partners, families and caregivers. If, for example, depression is not addressed, it may have negative consequences for the patient and healthcare system, including poorer patient health outcomes, quality of life and well-being, incomplete or failed return to work and attenuation of healthcare costs.3–5

Depression and anxiety are common among people with CVD: 30% of women and 20% of men report clinically relevant symptoms of depression; 39% of women and 22% of men report clinically relevant symptoms of anxiety.6 The prevalence of depression and anxiety is higher in CVD populations than in the general population.4 In some CVD populations, for example, with an implantable cardioverter defibrillator (ICD), over 50% meet the criteria for anxiety.7 Depression and anxiety are associated with being female, having a lower level of educational attainment, a sedentary or inactive lifestyle, more severe symptoms, poorer quality of life, increased risk of disease and death and increased healthcare costs.6 8 Moreover, as CVD and depression are the most common causes of disability in high income countries and predicted to remain among the top 10 of diseases worldwide until …

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  • Contributors DRT wrote the first draft and SSP contributed original material to the manuscript and provided revisions. DRT finalised the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Author note Author note References which include a * are considered to be key references.