Lederbogen F, Ströhle A
Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Universität Heidelberg, Medizinische Fakultät Mannheim, J5, 68159 Mannheim, Deutschland.
Nervenarzt. 2012 Nov;83(11):1448-57. doi: 10.1007/s00115-012-3666-7.
There are numerous associations between stress, mental disorders and coronary heart disease (CHD). Exposure to an acute stressor leads to activation of the hypothalamus-pituitary-adrenal and sympathoadrenal systems and chronic stressors are associated with sustained functional changes of these systems. Experiencing acute and chronic stress is paralleled by an increased incidence of mental disorders with the most consistent evidence on the triggering of major depressive episodes. Various mental disorders, including depression, anxiety and schizophrenia, are associated with an increased risk of CHD. Furthermore, acute and chronic stressors have been identified as risk factors or triggers of acute coronary syndromes. Thus therapeutic strategies aim at reducing subjective stress experience, therapy of mental disorders and treatment of cardiac risk factors known to be more prevalent in increased stress states and mental disorders.
压力、精神障碍与冠心病（CHD）之间存在众多关联。暴露于急性应激源会导致下丘脑 - 垂体 - 肾上腺系统和交感肾上腺系统的激活，而慢性应激源则与这些系统的持续功能变化相关。经历急性和慢性应激的同时，精神障碍的发病率也会增加，其中关于引发重度抑郁发作的证据最为一致。包括抑郁症、焦虑症和精神分裂症在内的各种精神障碍都与冠心病风险增加有关。此外，急性和慢性应激源已被确定为急性冠状动脉综合征的危险因素或触发因素。因此，治疗策略旨在减少主观压力体验、治疗精神障碍以及治疗已知在压力增加状态和精神障碍中更为普遍的心脏危险因素。
