Dept. of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Psychosomatics. 2012 Jul-Aug;53(4):303-18. doi: 10.1016/j.psym.2012.04.004.
Intervention research at the intersection of psychiatry and cardiology has primarily focused on the relationship between negative psychological syndromes (e.g., depression) and cardiac outcomes, with less emphasis on positive psychological attributes, such as optimism, gratitude, and well-being, as they relate to cardiac disease.
Literature is reviewed in three specific areas regarding positive attributes and cardiac disease: (1) associations between positive attributes and cardiac outcomes, (2) potential mechanisms-both behavioral and physiologic-by which positive psychological states may impact cardiovascular health, and (3) interventions aimed at cultivating positive psychological attributes in healthy and medically ill persons.
There is significant evidence that positive psychological attributes--especially optimism--may be independently associated with superior cardiac outcomes. Positive attributes appear to be associated with increased participation in cardiac health behaviors (e.g., healthy eating, physical activity) linked to beneficial outcomes; data linking positive psychological states and biomarkers of cardiac health (e.g., inflammatory markers) is mixed but suggests a potential association. Positive psychological interventions have consistently been associated with improved well-being and reduced depressive symptoms, though there have been few such studies in the medically ill.
These findings regarding the relationship between positive psychological attributes and cardiac health are promising and suggest that positive psychology interventions may be worth study in this population. However, questions remain about the strength and specificity of these relationships, the most salient positive psychological attributes, and the impact of positive psychological interventions on health outcomes in cardiac patients.
精神医学和心脏病学交叉领域的干预研究主要集中在负面心理综合征（如抑郁）与心脏结局之间的关系上，而对积极的心理属性（如乐观、感恩和幸福感）关注较少，尽管它们与心脏病有关。
本文在三个具体领域回顾了与积极属性和心脏病相关的文献：（1）积极属性与心脏结局之间的关联；（2）积极心理状态可能影响心血管健康的潜在行为和生理机制；（3）旨在培养健康和患病个体积极心理属性的干预措施。
有大量证据表明，积极的心理属性——尤其是乐观——可能与更好的心脏结局独立相关。积极的属性似乎与更多的心脏健康行为（如健康饮食、体育活动）有关，这些行为与有益的结果有关；将积极的心理状态与心脏健康的生物标志物（如炎症标志物）联系起来的数据喜忧参半，但表明可能存在关联。积极的心理干预措施一直与改善幸福感和减少抑郁症状有关，但在患病个体中此类研究较少。
这些关于积极心理属性与心脏健康之间关系的发现很有希望，表明积极心理干预措施在该人群中值得研究。然而，这些关系的强度和特异性、最显著的积极心理属性以及积极心理干预对心脏病患者健康结局的影响仍存在疑问。
