Psychosocial aspects of coronary heart disease

Acupuncture and the Cardiovascular System: A Scientific Challenge

In acupuncture research two main issues have to be addressed. One is whether the needle has a biological effect of its own. The other is whether acupuncture is of help to patients in their daily lives. With reference to this, acupuncture is a complex form of treatment in which the needles modulate physiological mechanisms of the body and the doctor supports the patient to achieve a life-style that assists with this.

To evaluate the biological effects of needling, a randomised, controlled trial group of 49 patients with angina pectoris had acupuncture while cardiological, neurophysiological and psychological observations were made in a mutually independent manner. Needling was found to improve the working capacity of the heart. In addition, acupuncture was found to activate cardiovascular autoregulatory mechanisms in 24 healthy persons.

To evaluate the effect of acupuncture in daily life, a controlled trial group of 69 patients with severe angina pectoris were followed for 2 years after treatment. The incidence of cardiac death or myocardial infarction was 7%, compared to 15–21% for the control group of published results concerning invasive treatments. Due to clinical improvement, surgery was postponed in 61% of the patients. The annual number of in-hospital days was reduced by 90%, leading to a US$ 12,000 saving for each patient.

Psychiatric morbidity during the early phase of coronary care for myocardial infarction: association with cardiac diagnosis and outcome

We evaluated the association of psychiatric morbidity during the early phase of admission to a coronary care unit with cardiac diagnosis and subsequent morbidity. Ninety-two patients admitted for the first time for presumed myocardial infarction were evaluated within 48 hours of hospitalization. Anxiety and depressive symptoms and cognitive impairment were rated. Data were collected on cardiac diagnosis and morbidity. Three and 12 months after hospitalization, cardiac morbidity, psychiatric symptoms and psychosocial morbidity were assessed.

What does the legacy of Hans Selye and Franz Alexander mean today? (The psychophysiological approach in medical practice)

At the founding session of the Working Group of Psychophysiology, Hungarian Psychiatric Society, the authors summarized the psychophysiological legacy of two Hungarian-born researchers, Hans Selye and Franz Alexander in medicine today. Emotional dysfunctions, anxiety and depression are a substantial risk factor in the emergence, course and recurrence of many illnesses of great epidemiological significance, such as ischemic heart diseases, in the prognosis of hormone-sensitive tumours in the middle-aged and, obviously, in alcoholism and suicide. In modern society the reduction of creative ability and the capacity for work is caused primarily not by physical damage, but rather by states of depression with anxiety and functional disorders arising as a result of transitional or lasting failure of the psychological capacities to resolve conflicts, leading to such states as chronic pain syndrome, functional cardiovascular and gastroenterological disorders. According to prognoses based on the above, lasting results can only be expected of preventive health programs if they take the results of modern psychophysiology seriously into account. On the basis of the recent theoretical achievements, we are capable not only of treating the symptoms but also of intervening in the causes. Psychotherapeutic methods and psychopharmacology supplement each other within this theoretical framework.