The author describes the frequencies and characteristics of psychopathological disorders before and after open heart surgery. In addition to cognitive and anxious-depressive mood disorders in the preoperative time, anxiety and coping are prominent. Postoperatively, different mood and cognitive disorders, psychotic reactions and delirious syndromes may be found. Conditions and causes of psychopathological disorders are discussed with the aid of the literature and present results. Therapeutic possibilities are outlined.