An integrative psychosomatic approach to the treatment of patients with cardiovascular diseases: Concepts and experiences of a dedicated psychocardiology ward at the university of göttingen medical center

Abstract

Mental comorbidity adversely affects quality of life, health behavior, and prognosis in cardiac patients. While this comorbidity goes untreated in many patients, others typically receive outpatient treatment with psychotherapy, antidepressant medication, or collaborative care. However, severity of heart disease or the mental disorders sometimes interferes with continuous outpatient treatment. For severely ill patients, simultaneous inpatient treatment of heart disease and mental comorbidity may become necessary. In the German healthcare system, statutory health insurance covers inpatient psychosomatic treatment if medically indicated. This chapter describes a model of integrated inpatient psychocardiology treatment as implemented on a dedicated ward at University of Göttingen Medical Center. The different components of the therapeutic program are outlined and vignettes of typical cases are presented. Clinical impressions and fi rst evaluation results suggest that the psychocardiology ward closes an important gap in the care of patients with severe comorbid heart disease and mental disorders or cardiac somatization.