Sub-Clinical Psychological Conditions Affecting Cardiovascular Disorders.

Using DSM criteria in medical settings, a basic question arises, that is whether patients who do not fulfil these criteria do not indeed present psychological problems which may affect the medical symptoms and are worthy of clinical attention. However, psychological symptoms and personality traits that do not satisfy traditional psychiatric criteria are not well defined; moreover, it is difficult to measure these subtypes of distress and there is always the need for a clinical judgement. In recent years psychosomatic research has focused increasing attention on these clinical and methodological issues. Psychosocial variables that were derived from psychosomatic research were then translated into operational tools, such as Diagnostic Criteria for Psychosomatic Research (DCPR). DCPR diagnoses such as demoralization, irritable mood, type A behavior, illness denial, alexithymia and health anxiety are frequently detected in cardiac patients. The joint use of DSM-IV and DCPR criteria allow then to identify psychological factors that seem to affect cardiologic condition. Clinical and therapeutic implications are discussed by the author.