Of Sound Heart and Mind: A Scoping Review of Risk and Protective Factors for Symptoms of Depression, Anxiety, and Posttraumatic Stress in People With Heart Disease

J Cardiovasc Nurs. 2018 Sep/Oct;33(5):E16-E28. doi: 10.1097/JCN.0000000000000508.

Abstract

Background: Heart disease is related to the etiology of mental health problems such as depression, anxiety, and posttraumatic stress.

Objective: The goal of this scoping review was to determine which factors pose a significant risk for the onset of symptoms of depression, anxiety, and posttraumatic stress in patients with heart disease, as well as to identify what might protect them from these afflictions.

Method: We conducted a thorough search of relevant medical and psychological databases (Scopus, PsycARTICLES, Psychology and Behavioral Sciences Collection, Sage Journals, and MEDLINE) and identified 41 studies that met inclusion criteria, which included all types of heart disease.

Results: The results of our review indicate that mental health history, the tendency to stifle negative emotional experiences (known as "type D personality"), and social support in patients with heart disease are related to the onset of or protection from depression, anxiety, and posttraumatic stress. These factors, along with gender and younger age, seem to be relatively consistent predictors of mental health problems in this population.

Conclusions: As per our results, it is important for clinicians to attend to the mental health history, type D personality, and presence and quality of social support in patients with heart disease. More research into prevention and gender differences is necessary to hone the detection and treatment of these problems in people with heart disease.

Clinical implications: Attention to their mental health history, their ability to express and regulate affect, their age, and their gender will most likely assist in identifying symptoms of depression, anxiety, and posttraumatic stress in people with cardiac disease. Gender differences, particularly in the manifestation of depression, ought to be taken into account.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Age Factors
  • Anxiety* / prevention & control
  • Anxiety* / psychology
  • Depression* / prevention & control
  • Depression* / psychology
  • Heart Diseases / psychology*
  • Humans
  • Mental Health
  • Sex Factors
  • Social Support
  • Stress Disorders, Post-Traumatic* / prevention & control
  • Stress Disorders, Post-Traumatic* / psychology
  • Type D Personality