Skip to main content
SpringerLink
Log in

Psychosocial Risk Factors in Women: Special Reference to Depression and Posttraumatic Stress Disorder

  • Chapter
  • First Online:
Psychosocial Stress and Cardiovascular Disease in Women

Abstract

Women have a higher susceptibility than men to a set of psychosocial factors that have been linked to increased risk of ischemic heart disease (IHD), such as depression, early life adversities, and posttraumatic stress disorder (PTSD). In this chapter we discuss the notion that these psychosocial risk factors, particularly if they are present at young age, may set a trajectory of increased IHD risk in women, even though clinical events may occur years later. Emerging data suggest that young women are uniquely susceptible to the adverse cardiovascular effects psychosocial stress, which can result in earlier onset of IHD or more adverse prognosis if the disease is already manifest. Women’s vulnerability to psychosocial stress could also play a role in sex differences in the pathophysiology of IHD; for example it could help explain their higher propensity to abnormal coronary vasomotion and micro-vascular disease, which has been described in women compared with men. Young women are severely under-represented in studies of cardiovascular disease. In future research, it will be crucial to study women earlier in their life to better understand the risk pathways linking psychosocial stress to IHD risk, in order to devise successful preventive and treatment strategies to ameliorate such risk.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ahmadi, N., Hajsadeghi, F., Mirshkarlo, H. B., Budoff, M., Yehuda, R., & Ebrahimi, R. (2011). Post-traumatic stress disorder, coronary atherosclerosis, and mortality. American Journal of Cardiology, 108, 29–33.

    PubMed  Google Scholar 

  • Albert, C. M., Chae, C. U., Rexrode, K. M., Manson, J. E., & Kawachi, I. (2005). Phobic anxiety and risk of coronary heart disease and sudden cardiac death among women. Circulation, 111, 480–487.

    PubMed  Google Scholar 

  • Alonso, J., Angermeyer, M. C., Bernert, S., Bruffaerts, R., Brugha, T. S., Bryson, H., de Girolamo, G., Graaf, R., Demyttenaere, K., Gasquet, I., Haro, J. M., Katz, S. J., Kessler, R. C., Kovess, V., Lepine, J. P., Ormel, J., Polidori, G., Russo, L. J., Vilagut, G., Almansa, J., Arbabzadeh-Bouchez, S., Autonell, J., Bernal, M., Buist-Bouwman, M. A., Codony, M., Domingo-Salvany, A., Ferrer, M., Joo, S. S., Martinez-Alonso, M., Matschinger, H., Mazzi, F., Morgan, Z., Morosini, P., Palacin, C., Romera, B., Taub, N., Vollebergh, W. A., & EsemeD/Mhedea EsemeD/Mhedea Investigators, European Study of the Epidemiology of Mental Disorders Project. (2004). Prevalence of mental disorders in Europe: Results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta psychiatrica Scandinavica. Supplementum, 420, 21–27.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, Text revision (4th ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th Ed.). Arlington, VA: Author.

    Google Scholar 

  • Andrikopoulos, G. K., Tzeis, S. E., Pipilis, A. G., Richter, D. J., Kappos, K. G., Stefanadis, C. I., Toutouzas, P. K., & Chimonas, E. T. (2006). Younger age potentiates post myocardial infarction survival disadvantage of women. International Journal of Cardiology, 108, 320–325.

    PubMed  Google Scholar 

  • Arrighi, J. A., Burg, M., Cohen, I. S., Kao, A. H., Pfau, S., Caulin-Glaser, T., Zaret, B. L., & Soufer, R. (2000). Myocardial blood-flow response during mental stress in patients with coronary artery disease. Lancet, 356, 310–311.

    PubMed  Google Scholar 

  • Ayuso-Mateos, J. L., Vazquez-Barquero, J. L., Dowrick, C., Lehtinen, V., Dalgard, O. S., Casey, P., Wilkinson, C., Lasa, L., Page, H., Dunn, G., Wilkinson, G., & Group, Odin. (2001). Depressive disorders in Europe: prevalence figures from the ODIN study. The British Journal of Psychiatry, 179, 308–316.

    Google Scholar 

  • Baccarelli, A., Rienstra, M., & Benjamin, E. J. (2010). Cardiovascular epigenetics: Basic concepts and results from animal and human studies. Circulation, 3, 567–573.

    PubMed Central  PubMed  Google Scholar 

  • Batten, S. V., Aslan, M., Maciejewski, P. K., & Mazure, C. M. (2004). Childhood maltreatment as a risk factor for adult cardiovascular disease and depression. Journal of Clinical Psychiatry, 65, 249–254.

    PubMed  Google Scholar 

  • Baumeister, H., Hutter, N., & Bengel, J. (2011). Psychological and pharmacological interventions for depression in patients with coronary artery disease. Cochrane Database of Systematic Reviews (9):CD008012. doi: 10.1002/14651858.CD008012.pub3.

  • Becker, L. C., Pepine, C. J., Bonsall, R., Cohen, J. D., Goldberg, A. D., Coghlan, C., Stone, P. H., Forman, S., Knatterud, G., Sheps, D. S., & Kaufmann, P. G. (1996). Left ventricular, peripheral vascular, and neurohumoral responses to mental stress in normal middle-aged men and women. Reference Group for the Psychophysiological Investigations of Myocardial Ischemia (PIMI) Study. Circulation, 94, 2768–2777.

    PubMed  Google Scholar 

  • Berga, S. L. (2008). Stress and reproduction: A tale of false dichotomy? Endocrinology, 149, 867–868.

    PubMed  Google Scholar 

  • Berga, S. L., & Loucks, T. L. (2005). The diagnosis and treatment of stress-induced anovulation. Minerva Ginecologica, 57, 45–54.

    PubMed  Google Scholar 

  • Bierhaus, A., Wolf, J., Andrassy, M., Rohleder, N., Humpert, P. M., Petrov, D., Ferstl, R., von Eynatten, M., Wendt, T., Rudofsky, G., Joswig, M., Morcos, M., Schwaninger, M., McEwen, B., Kirschbaum, C., & Nawroth, P. P. (2003). A mechanism converting psychosocial stress into mononuclear cell activation. Proceedings of the National Academy of Sciences of the United States of America, 100, 1920–1925.

    PubMed Central  PubMed  Google Scholar 

  • Bigger, J., Fleiss, J., Steinman, R., Rolnitsky, L., Kleiger, R., & Rottman, J. (1992). Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation, 85, 164–171.

    PubMed  Google Scholar 

  • Blanchard, E. B., Kolb, L. C., Pallmeyer, T. P., & Gerardi, R. J. (1982). A psychophysiological study of post-traumatic stress disorder in Vietnam veterans. Psychiatric Quarterly, 54, 220–229.

    PubMed  Google Scholar 

  • Blanchard, E. B., Kolb, L. C., Prins, A., Gates, S., & McCoy, G. C. (1991). Changes in plasma norepinephrine to combat-related stimuli among Vietnam veterans with posttraumatic stress disorder. Journal of Nervous and Mental Disease, 179, 371–373.

    PubMed  Google Scholar 

  • Boscarino, J. A. (2008). A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: Implications for surveillance and prevention. Psychosomatic Medicine, 70, 668–676.

    PubMed Central  PubMed  Google Scholar 

  • Bremner, J. D. (2003). Long-term effects of childhood abuse on brain and neurobiology. Child and Adolescent Psychiatric Clinics of North America, 12, 271–292.

    PubMed  Google Scholar 

  • Bremner, J. D. (2012). Brain and trauma. In C. R. Figley (Ed.), Encyclopedia of trauma: An interdisciplinary guide. Los Angeles, CA: SAGE Publications.

    Google Scholar 

  • Bremner, J. D., & Charney, D. S. (2010). Neural circuits in fear and anxiety. In D. J. Stein, E. Hollander, & B. O. Rothbaum (Eds.), Textbook of anxiety disorders (pp. 55–71). Arlington, VA: American Psychiatric.

    Google Scholar 

  • Breslau, N., Davis, G. C., & Schultz, L. R. (2003). Posttraumatic stress disorder and the incidence of nicotine, alcohol, and other drug disorders in persons who have experienced trauma. Archives of General Psychiatry, 60, 289–294.

    PubMed  Google Scholar 

  • Brown, D. W., Anda, R. F., Tiemeier, H., Felitti, V. J., Edwards, V. J., Croft, J. B., & Giles, W. H. (2009). Adverse childhood experiences and the risk of premature mortality. American Journal of Preventive Medicine, 37, 389–396.

    PubMed  Google Scholar 

  • Bugiardini, R., & Bairey Merz, C. N. (2005). Angina with “normal” coronary arteries: a changing philosophy. Journal of the American Medical Association, 293, 477–484.

    PubMed  Google Scholar 

  • Burg, M. M., Graeber, B., Vashist, A., Collins, D., Earley, C., Liu, J., Lampert, R., & Soufer, R. (2009). Noninvasive detection of risk for emotion-provoked myocardial ischemia. Psychosomatic Medicine, 71, 14–20.

    PubMed Central  PubMed  Google Scholar 

  • Caldji, C., Tannenbaum, B., Sharma, S., Francis, D., Plotsky, P. M., & Meaney, M. J. (1998). Maternal care during infancy regulates the development of neural systems mediating the expression of fearfulness in the rat. Proceedings of the National Academy of Sciences of the United States of America, 95, 5335–5340.

    PubMed Central  PubMed  Google Scholar 

  • Carney, R. M., Blumenthal, J. A., Freedland, K. E., Stein, P. K., Howells, W. B., Berkman, L. F., Watkins, L. L., Czajkowski, S. M., Hayano, J., Domitrovich, P. P., & Jaffe, A. S. (2005a). Low heart rate variability and the effect of depression on post-myocardial infarction mortality. Archives of Internal Medicine, 165, 1486–1491.

    PubMed  Google Scholar 

  • Carney, R. M., Freedland, K. E., Eisen, S. A., Rich, M. W., & Jaffe, A. S. (1995). Major depression and medication adherence in elderly patients with coronary artery disease. Health Psychology, 14, 88–90.

    PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2010). Adverse childhood experiences reported by adults—Five states, 2009. Morbidity and Mortality Weekly Report, 59, 1609–1613.

    Google Scholar 

  • Chrousos, G. P., Torpy, D. J., & Gold, P. W. (1998). Interactions between the hypothalamic-pituitary-adrenal axis and the female reproductive system: clinical implications. Annals of Internal Medicine, 129, 229–240.

    PubMed  Google Scholar 

  • Danese, A., Caspi, A., Williams, B., Ambler, A., Sugden, K., Mika, J., Werts, H., Freeman, J., Pariante, C. M., Moffitt, T. E., & Arseneault, L. (2011). Biological embedding of stress through inflammation processes in childhood. Molecular Psychiatry, 16, 244–246.

    PubMed Central  PubMed  Google Scholar 

  • Danese, A., & McEwen, B. S. (2012). Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiology and Behavior, 106, 29–39.

    PubMed  Google Scholar 

  • Danese, A., Pariante, C. M., Caspi, A., Taylor, A., & Poulton, R. (2007). Childhood maltreatment predicts adult inflammation in a life-course study. Proceedings of the National Academy of Sciences of the United States of America, 104, 1319–1324.

    PubMed Central  PubMed  Google Scholar 

  • de Jong, J. T., Komproe, I. H., Van Ommeren, M., El Masri, M., Araya, M., Khaled, N., van De Put, W., & Somasundaram, D. (2001). Lifetime events and posttraumatic stress disorder in 4 postconflict settings. JAMA, 286(5), 555–562.

    Google Scholar 

  • de Geus, E. J. (2006). Genetic pleiotropy in depression and coronary artery disease. Psychosomatic Medicine, 68, 185–186.

    PubMed  Google Scholar 

  • de Vries, G. J., & Olff, M. (2009). The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands. Journal of Traumatic Stress, 22(4), 259–267.

    Google Scholar 

  • Eaker, E. D., Sullivan, L. M., Kelly-Hayes, M., D’Agostino, R. B., Sr., & Benjamin, E. J. (2005). Tension and anxiety and the prediction of the 10-year incidence of coronary heart disease, atrial fibrillation, and total mortality: the Framingham Offspring Study. Psychosomatic Medicine, 67, 692–696.

    PubMed  Google Scholar 

  • Egger, G., Liang, G., Aparicio, A., & Jones, P. A. (2004). Epigenetics in human disease and prospects for epigenetic therapy. Nature, 429, 457–463.

    PubMed  Google Scholar 

  • Elklit, A. (2002). Victimization and PTSD in a Danish national youth probability sample. J. Am. Acad. Child Adolesc. Journal of the American Academy of Child and Adolescent Psychiatry, 41(2), 174–181.

    Google Scholar 

  • Empana, J. P., Sykes, D. H., Luc, G., Juhan-Vague, I., Arveiler, D., Ferrieres, J., Amouyel, P., Bingham, A., Montaye, M., Ruidavets, J. B., Haas, B., Evans, A., Jouven, X., Ducimetiere, P., & for the PSG. (2005). Contributions of depressive mood and circulating inflammatory markers to coronary heart disease in healthy European men: The Prospective Epidemiological Study of Myocardial Infarction (PRIME). Circulation, 111, 2299–2305.

    PubMed  Google Scholar 

  • Ferin, M. (1999). Clinical review 105: Stress and the reproductive cycle. Journal of Clinical Endocrinology and Metabolism, 84, 1768–1774.

    PubMed  Google Scholar 

  • Fraga, M. F., Ballestar, E., Paz, M. F., Ropero, S., Setien, F., Ballestar, M. L., Heine-Suner, D., Cigudosa, J. C., Urioste, M., Benitez, J., Boix-Chornet, M., Sanchez-Aguilera, A., Ling, C., Carlsson, E., Poulsen, P., Vaag, A., Stephan, Z., Spector, T. D., Wu, Y. Z., Plass, C., & Esteller, M. (2005). Epigenetic differences arise during the lifetime of monozygotic twins. Proceedings of the National Academy of Sciences of the United States of America, 102, 10604–10609.

    PubMed Central  PubMed  Google Scholar 

  • Frasure-Smith, N., & Lesperance, F. (2008). Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Archives of General Psychiatry, 65, 62–71.

    PubMed  Google Scholar 

  • Frasure-Smith, N., Lesperance, F., Juneau, M., Talajic, M., & Bourassa, M. G. (1999). Gender, depression, and one-year prognosis after myocardial infarction. Psychosomatic Medicine, 61, 26–37.

    PubMed  Google Scholar 

  • Fuchikami, M., Yamamoto, S., Morinobu, S., Takei, S., & Yamawaki, S. (2010). Epigenetic regulation of BDNF gene in response to stress. Psychiatry Investigation, 7, 251–256.

    PubMed Central  PubMed  Google Scholar 

  • Ghiadoni, L., Donald, A. E., Cropley, M., Mullen, M. J., Oakley, G., Taylor, M., O'Connor, G., Betteridge, J., Klein, N., Steptoe, A., & Deanfield, J. E. (2000). Mental stress induces transient endothelial dysfunction in humans. Circulation, 102, 2473–2478.

    PubMed  Google Scholar 

  • Gilmer, W. S., & McKinney, W. T. (2003). Early experience and depressive disorders: Human and non-human primate studies. Journal of Affective Disorders, 75, 97–113.

    PubMed  Google Scholar 

  • Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Borden, W. B., Bravata, D. M., Dai, S., Ford, E. S., Fox, C. S., Franco, S., Fullerton, H. J., Gillespie, C., Hailpern, S. M., Heit, J. A., Howard, V. J., Huffman, M. D., Kissela, B. M., Kittner, S. J., Lackland, D. T., Lichtman, J. H., Lisabeth, L. D., Magid, D., Marcus, G. M., Marelli, A., Matchar, D. B., McGuire, D. K., Mohler, E. R., Moy, C. S., Mussolino, M. E., Nichol, G., Paynter, N. P., Schreiner, P. J., Sorlie, P. D., Stein, J., Turan, T. N., Virani, S. S., Wong, N. D., Woo, D., Turner, M. B., & American Heart Association Statistics C, Stroke Statistics S. (2013). Heart disease and stroke statistics—2013 update: A report from the American Heart Association. Circulation, 127(1), 143–152. doi: 10.1161/CIR.0b013e318282ab8f. Review.

    PubMed  Google Scholar 

  • Goldberg, A. D., Becker, L. C., Bonsall, R., Cohen, J. D., Ketterer, M. W., Kaufman, P. G., Krantz, D. S., Light, K. C., McMahon, R. P., Noreuil, T., Pepine, C. J., Raczynski, J., Stone, P. H., Strother, D., Taylor, H., & Sheps, D. S. (1996). Ischemic, hemodynamic, and neurohormonal responses to mental and exercise stress. Experience from the Psychophysiological Investigations of Myocardial Ischemia Study (PIMI). Circulation, 94, 2402–2409.

    PubMed  Google Scholar 

  • Goodwin, R. D., & Stein, M. B. (2004). Association between childhood trauma and physical disorders among adults in the United States. Psychological Medicine, 34, 509–520.

    PubMed  Google Scholar 

  • Gullette, E. C., Blumenthal, J. A., Babyak, M., Jiang, W., Waugh, R. A., Frid, D. J., O’Connor, C. M., Morris, J. J., & Krantz, D. S. (1997). Effect of mental stress on myocardial ischemia during daily life. Journal of the American Medical Association, 277, 1521–1526.

    PubMed  Google Scholar 

  • Gunnell, D. J., & Ewings, P. (1994). Infertility prevalence, needs assessment and purchasing. Journal of Public Health Medicine, 16, 29–35.

    PubMed  Google Scholar 

  • Heim, C., Newport, D. J., Heit, S., Graham, Y. P., Wilcox, M., Bonsall, R., Miller, A. H., & Nemeroff, C. B. (2000). Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. Journal of the American Medical Association, 284, 592–597.

    PubMed  Google Scholar 

  • Heim, C., Plotsky, P. M., & Nemeroff, C. B. (2004). Importance of studying the contributions of early adverse experience to neurobiological findings in depression. Neuropsychopharmacology, 29, 641–648.

    PubMed  Google Scholar 

  • Highlights of Changes from DSM-IV-TR to DSM-5 (PDF). (2013). American Psychiatric Association. 17 May 2013. Accessed 5 Aug.

    Google Scholar 

  • Hoge, E. A., Brandstetter, K., Moshier, S., Pollack, M. H., Wong, K. K., & Simon, N. M. (2009). Broad spectrum of cytokine abnormalities in panic disorder and posttraumatic stress disorder. Depression and Anxiety, 26, 447–455.

    PubMed  Google Scholar 

  • Jain, D., Shaker, S. M., Burg, M., Wackers, F. J., Soufer, R., & Zaret, B. L. (1998). Effects of mental stress on left ventricular and peripheral vascular performance in patients with coronary artery disease. Journal of the American College of Cardiology, 31, 1314–1322.

    PubMed  Google Scholar 

  • Jiang, W., Samad, Z., Boyle, S., Becker, R. C., Williams, R., Kuhn, C., Ortel, T. L., Rogers, J., Kuchibhatla, M., O'Connor, C., & Velazquez, E. J. (2013). Prevalence and clinical characteristics of mental stress-induced myocardial ischemia in patients with coronary heart disease. Journal of the American College of Cardiology, 61, 714–722.

    PubMed Central  PubMed  Google Scholar 

  • Jones, D. J., Bromberger, J. T., Sutton-Tyrrell, K., & Matthews, K. A. (2003). Lifetime history of depression and carotid atherosclerosis in middle-aged women. Archives of General Psychiatry, 60, 153–160.

    PubMed  Google Scholar 

  • Kaplan, J. R., Chen, H., & Manuck, S. B. (2009). The relationship between social status and atherosclerosis in male and female monkeys as revealed by meta-analysis. American Journal of Primatology, 71, 732–741.

    PubMed Central  PubMed  Google Scholar 

  • Kaplan, J. R., & Manuck, S. B. (2008). Ovarian dysfunction and the premenopausal origins of coronary heart disease. Menopause, 15, 768–776.

    PubMed  Google Scholar 

  • Kaplan, J. R., Manuck, S. B., Anthony, M. S., & Clarkson, T. B. (2002). Premenopausal social status and hormone exposure predict postmenopausal atherosclerosis in female monkeys. Obstetrics and Gynecology, 99, 381–388.

    PubMed  Google Scholar 

  • Kendler, K. S., Gardner, C. O., Fiske, A., & Gatz, M. (2009). Major depression and coronary artery disease in the Swedish Twin Registry: Phenotypic, genetic, and environmental sources of comorbidity. Archives of General Psychiatry, 66, 857–863.

    PubMed Central  PubMed  Google Scholar 

  • Kendler, K. S., Gardner, C. O., Neale, M. C., & Prescott, C. A. (2001). Genetic risk factors for major depression in men and women: Similar or different heritabilities and same or partly distinct genes? Psychological Medicine, 31, 605–616.

    PubMed  Google Scholar 

  • Kendler, K. S., Gatz, M., Gardner, C. O., & Pedersen, N. L. (2006). A Swedish national twin study of lifetime major depression. The American Journal of Psychiatry, 163, 109–114.

    PubMed  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62, 617–627.

    PubMed Central  PubMed  Google Scholar 

  • Kleim, B., Wilhelm, F. H., Glucksman, E., & Ehlers, A. (2010). Sex differences in heart rate responses to script-driven imagery soon after trauma and risk of posttraumatic stress disorder. Psychosomatic Medicine, 72, 917–924.

    PubMed Central  PubMed  Google Scholar 

  • Koek, H. L., de Bruin, A., Gast, F., Gevers, E., Kardaun, J. W. P. F., Reitsma, J. B., Grobbee, D. E., & Bots, M. L. (2006). Short- and long-term prognosis after acute myocardial infarction in men versus women. The American Journal of Cardiology, 98, 993–999.

    PubMed  Google Scholar 

  • Kop, W. J., Krantz, D. S., Howell, R. H., Ferguson, M. A., Papademetriou, V., Lu, D., Popma, J. J., Quigley, J. F., Vernalis, M., & Gottdiener, J. S. (2001). Effects of mental stress on coronary epicardial vasomotion and flow velocity in coronary artery disease: Relationship with hemodynamic stress responses. Journal of the American College of Cardiology, 37, 1359–1366.

    PubMed  Google Scholar 

  • Korkeila, J., Vahtera, J., Korkeila, K., Kivimaki, M., Sumanen, M., Koskenvuo, K., & Koskenvuo, M. (2010). Childhood adversities as predictors of incident coronary heart disease and cerebrovascular disease. Heart, 6, 298–303.

    Google Scholar 

  • Kostis, J. B., Wilson, A. C., O’Dowd, K., Gregory, P., Chelton, S., Cosgrove, N. M., Chirala, A., & Cui, T. (1994). Sex differences in the management and long-term outcome of acute myocardial infarction. Circulation, 90, 1715–1730.

    PubMed  Google Scholar 

  • Kubzansky, L. D., Koenen, K. C., Jones, C., & Eaton, W. W. (2009). A prospective study of posttraumatic stress disorder symptoms and coronary heart disease in women. Health Psychology, 28, 125–130.

    PubMed Central  PubMed  Google Scholar 

  • Kubzansky, L. D., Koenen, K. C., Spiro, A., 3rd, Vokonas, P. S., & Sparrow, D. (2007). Prospective study of posttraumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study. Archives of General Psychiatry, 64, 109–116.

    PubMed  Google Scholar 

  • Kuehner, C. (2003). Gender differences in unipolar depression: An update of epidemiological findings and possible explanations. Acta Psychiatrica Scandinavica, 2003(108), 163–174.

    Google Scholar 

  • La Rovere, M. T., Bigger, J. T., Jr., Marcus, F. I., Mortara, A., & Schwartz, P. J. (1998). Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. ATRAMI (Autonomic tone and reflexes after myocardial infarction) investigators. Lancet, 351, 478–484.

    PubMed  Google Scholar 

  • Ladd, C. O., Huot, R. L., Thrivikraman, K. V., Nemeroff, C. B., Meaney, M. J., & Plotsky, P. M. (2000). Long-term behavioral and neuroendocrine adaptations to adverse early experience. In E. A. Mayer & C. B. Saper (Eds.), Progress in brain research: The biological basis for mind body interactions (pp. 81–103). Amsterdam, The Netherlands: Elsevier.

    Google Scholar 

  • Lampert, R., Joska, T., Burg, M. M., Batsford, W. P., McPherson, C. A., & Jain, D. (2002). Emotional and physical precipitants of ventricular arrhythmia. Circulation, 106, 1800–1805.

    PubMed  Google Scholar 

  • Lane, R. D., Laukes, C., Marcus, F. I., Chesney, M. A., Sechrest, L., Gear, K., Fort, C. L., Priori, S. G., Schwartz, P. J., & Steptoe, A. (2005). Psychological stress preceding idiopathic ventricular fibrillation. Psychosomatic Medicine, 67, 359–365.

    PubMed  Google Scholar 

  • Lesperance, F., Frasure-Smith, N., Theroux, P., & Irwin, M. (2004). The association between major depression and levels of soluble intercellular adhesion molecule 1, interleukin-6, and C-reactive protein in patients with recent acute coronary syndromes. The American Journal of Psychiatry, 161, 271–277.

    PubMed  Google Scholar 

  • Linden, W., Phillips, M. J., & Leclerc, J. (2007). Psychological treatment of cardiac patients: A meta-analysis. European Heart Journal, 28, 2972–2984.

    PubMed  Google Scholar 

  • Low, C. A., Thurston, R. C., & Matthews, K. A. (2010). Psychosocial factors in the development of heart disease in women: Current research and future directions. Psychosomatic Medicine, 72, 842–854.

    PubMed Central  PubMed  Google Scholar 

  • Mahon, N. G., McKenna, C. J., Codd, M. B., O’Rorke, C., McCann, H. A., & Sugrue, D. D. (2000). Gender differences in the management and outcome of acute myocardial infarction in unselected patients in the thrombolytic era. American Journal of Cardiology, 85, 921–926.

    PubMed  Google Scholar 

  • Mallik, S., Spertus, J. A., Reid, K. J., Krumholz, H. M., Rumsfeld, J. S., Weintraub, W. S., Agarwal, P., Santra, M., Bidyasar, S., Lichtman, J. H., Wenger, N. K., & Vaccarino, V. (2006). Depressive symptoms after acute myocardial infarction: Evidence for highest rates in younger women. Archives of Internal Medicine, 166, 876–883.

    PubMed  Google Scholar 

  • Marcus, M. D., Loucks, T. L., & Berga, S. L. (2001). Psychological correlates of functional hypothalamic amenorrhea. Fertility and Sterility, 76, 310–316.

    PubMed  Google Scholar 

  • McEwen, B. S. (2008). Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. European Journal of Pharmacology, 583, 174–185.

    PubMed Central  PubMed  Google Scholar 

  • McFall, M. E., Murburg, M. M., Ko, G. N., & Veith, R. C. (1990). Autonomic responses to stress in Vietnam combat veterans with posttraumatic stress disorder. Biological Psychiatry, 27, 1165–1175.

    PubMed  Google Scholar 

  • McGowan, P. O., Sasaki, A., D’Alessio, A. C., Dymov, S., Labonte, B., Szyf, M., Turecki, G., & Meaney, M. J. (2009). Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nature Neuroscience, 12, 342–348.

    PubMed Central  PubMed  Google Scholar 

  • Meaney, M. J., & Szyf, M. (2005). Environmental programming of stress responses through DNA methylation: Life at the interface between a dynamic environment and a fixed genome. Dialogues in Clinical Neuroscience, 7, 103–123.

    PubMed Central  PubMed  Google Scholar 

  • Mehta, D., Klengel, T., Conneely, K. N., Smith, A. K., Altmann, A., Pace, T. W., Rex-Haffner, M., Loeschner, A., Gonik, M., Mercer, K. B., Bradley, B., Muller-Myhsok, B., Ressler, K. J., & Binder, E. B. (2013). Childhood maltreatment is associated with distinct genomic and epigenetic profiles in posttraumatic stress disorder. Proceedings of the National Academy of Sciences of the United States of America, 110, 8302–8307.

    PubMed Central  PubMed  Google Scholar 

  • Mulle, J. G., & Vaccarino, V. (2013). Cardiovascular disease, psychosocial factors, and genetics: The case of depression. Progress in Cardiovascular Diseases, 55, 557–562.

    PubMed Central  PubMed  Google Scholar 

  • Nicholson, A., Kuper, H., & Hemingway, H. (2006). Depression as an aetiologic and prognostic factor in coronary heart disease: A meta-analysis of 6362 events among 146 538 participants in 54 observational studies. European Heart Journal, 7, 2763–2774.

    Google Scholar 

  • Parashar, S., Rumsfeld, J. S., Reid, K. J., Buchanan, D., Dawood, N., Khizer, S., Lichtman, J., Vaccarino, V., & for the PRI. (2009). Impact of depression on sex differences in outcome after myocardial infarction. Circulation, 2, 33–40.

    PubMed  Google Scholar 

  • Pepine, C. J., Anderson, R. D., Sharaf, B. L., Reis, S. E., Smith, K. M., Handberg, E. M., Johnson, B. D., Sopko, G., & Bairey Merz, C. N. (2010). Coronary microvascular reactivity to adenosine predicts adverse outcome in women evaluated for suspected ischemia: Results from the National Heart, Lung and Blood Institute WISE (Women’s Ischemia Syndrome Evaluation) Study. Journal of the American College of Cardiology, 55, 2825–2832.

    PubMed Central  PubMed  Google Scholar 

  • Pitman, R. K., Orr, S. P., Forgue, D. F., Altman, B., de Jong, J. B., & Herz, L. R. (1990). Psychophysiologic responses to combat imagery of Vietnam veterans with posttraumatic stress disorder versus other anxiety disorders. Journal of Abnormal Psychology, 99, 49–54.

    PubMed  Google Scholar 

  • Plotsky, P. M., & Meaney, M. J. (1993). Early postnatal experience alters hypothalamic corticotropin-releasing factor (CRF) mRNA, median eminence CRF content and stress induced release in adult rats. Molecular Brain Research, 18, 195–200.

    PubMed  Google Scholar 

  • Reed, R. V., Fazel, M., & Goldring, L. (2012). Post-traumatic stress disorder. BMJ, 344, e3790. doi:10.1136/bmj.e3790.

    PubMed  Google Scholar 

  • Reese, C., Pederson, T., Avila, S., Joseph, K., Nagy, K., Dennis, A., Wiley, D., Starr, F., & Bokhari, F. (2012). Screening for traumatic stress among survivors of urban trauma. The Journal of Trauma and Acute Care Surgery, 73(2), 462–467. doi:10.1097/TA.0b013e31825ff713. discussion 467-8.

    PubMed  Google Scholar 

  • Rich-Edwards, J. W., Mason, S., Rexrode, K., Spiegelman, D., Hibert, E., Kawachi, I., Jun, H. J., & Wright, R. J. (2012). Physical and sexual abuse in childhood as predictors of early-onset cardiovascular events in women. Circulation, 126, 920–927.

    PubMed Central  PubMed  Google Scholar 

  • Ringback Weitoft, G., & Rosen, M. (2005). Is perceived nervousness and anxiety a predictor of premature mortality and severe morbidity? A longitudinal follow up of the Swedish survey of living conditions. Journal of Epidemiology and Community Health, 59, 794–798.

    PubMed  Google Scholar 

  • Roest, A. M., Martens, E. J., de Jonge, P., & Denollet, J. (2010). Anxiety and risk of incident coronary heart disease: A meta-analysis. Journal of the American College of Cardiology, 56, 38–46.

    PubMed  Google Scholar 

  • Rosengren, A., Spetz, C. L., Koster, M., Hammar, N., Alfredsson, L., & Rosen, M. (2001). Sex differences in survival after myocardial infarction in Sweden. Data from the Swedish National Acute Myocardial Infarction register. European Heart Journal, 22, 314–322.

    PubMed  Google Scholar 

  • Rosengren, A., Hawken, S., Ounpuu, S., Sliwa, K., Zubaid, M., Almahmeed, Wael A, Blackett, K.N., Sitthi-amorn, C., Sato, H., & Yusuf, S. (2004). Association of psychosocial risk factors with risk of acute myocardial infarction in 11 119 cases and 13,648 controls from 52 countries (the INTERHEART study): case-control study. Lancet, 364(9438), 953–962.

    Google Scholar 

  • Rozanski, A., Blumenthal, J. A., & Kaplan, J. (1999). Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation, 99, 2192–2217.

    PubMed  Google Scholar 

  • Ruo, B., Rumsfeld, J. S., Hlatky, M. A., Liu, H., Browner, W. S., & Whooley, M. A. (2003). Depressive symptoms and health-related quality of life: The Heart and Soul Study. Journal of the American Medical Association, 290, 215–221.

    PubMed Central  PubMed  Google Scholar 

  • Rutledge, T., Reis, S. E., Olson, M. B., Owens, J., Kelsey, S. F., Pepine, C. J., Mankad, S., Rogers, W. J., Merz, C. N., Sopko, G., Cornell, C. E., Sharaf, B., Matthews, K. A., & Vaccarino, V. (2006). Depression symptom severity and reported treatment history in the prediction of cardiac risk in women with suspected myocardial ischemia: The NHLBI-sponsored WISE study. Archives of General Psychiatry, 63, 874–880.

    PubMed  Google Scholar 

  • Sanchez, M. M., Ladd, C. O., & Plotsky, P. M. (2001). Early adverse experience as a developmental risk factor for later psychopathology: Evidence from rodent and primate models. Development and Psychopathology, 13, 419–449.

    PubMed  Google Scholar 

  • Shah, A. J., Lampert, R., Goldberg, J., Veledar, E., Bremner, J. D., & Vaccarino, V. (2013). Posttraumatic stress disorder and impaired autonomic modulation in male twins. Biological Psychiatry, 73, 1103–1110.

    PubMed Central  PubMed  Google Scholar 

  • Shah, A. J., Veledar, E., Hong, Y., Bremner, J. D., & Vaccarino, V. (2011). Depression and history of attempted suicide as risk factors for heart disease mortality in young individuals. Archives of General Psychiatry, 68, 1135–1142.

    PubMed Central  PubMed  Google Scholar 

  • Sherwood, A., Hinderliter, A. L., Watkins, L. L., Waugh, R. A., & Blumenthal, J. A. (2005). Impaired endothelial function in coronary heart disease patients with depressive symptomatology. Journal of the American College of Cardiology, 46, 656–659.

    PubMed  Google Scholar 

  • Smoller, J. W., Pollack, M. H., Wassertheil-Smoller, S., Jackson, R. D., Oberman, A., Wong, N. D., & Sheps, D. (2007). Panic attacks and risk of incident cardiovascular events among postmenopausal women in the Women’s Health Initiative Observational Study. Archives of General Psychiatry, 64, 1153–1160.

    PubMed  Google Scholar 

  • Spitzer, C., Barnow, S., Volzke, H., Wallaschofski, H., John, U., Freyberger, H. J., Lowe, B., & Grabe, H. J. (2010). Association of posttraumatic stress disorder with low-grade elevation of C-reactive protein: Evidence from the general population. Journal of Psychiatric Research, 44, 15–21.

    PubMed  Google Scholar 

  • Steptoe, A., Fieldman, G., Evans, O., & Perry, L. (1996). Cardiovascular risk and responsivity to mental stress: The influence of age, gender and risk factors. Journal of Cardiovascular Risk, 3, 83–93.

    PubMed  Google Scholar 

  • Substance Abuse and Mental Health Services Administration. (2012). Results from the 2011 National Survey on Drug Use and Health: Mental Health Findings. NSDUH Series H-45, HHS Publication No. (SMA) 12-4725.

    Google Scholar 

  • Sullivan, P. F., Neale, M. C., & Kendler, K. S. (2000). Genetic epidemiology of major depression: Review and meta-analysis. The American Journal of Psychiatry, 157, 1552–1562.

    PubMed  Google Scholar 

  • Turner, J. H., Neylan, T. C., Schiller, N. B., Li, Y., & Cohen, B. E. (2013). Objective evidence of myocardial ischemia in patients with posttraumatic stress disorder. Biological Psychiatry, 74, 861–866.

    Google Scholar 

  • Uddin, M., Aiello, A. E., Wildman, D. E., Koenen, K. C., Pawelec, G., de Los Santos, R., Goldmann, E., & Galea, S. (2010). Epigenetic and immune function profiles associated with posttraumatic stress disorder. Proceedings of the National Academy of Sciences of the United States of America, 107, 9470–9475.

    PubMed Central  PubMed  Google Scholar 

  • Unternaehrer, E., Luers, P., Mill, J., Dempster, E., Meyer, A. H., Staehli, S., Lieb, R., Hellhammer, D. H., & Meinlschmidt, G. (2012). Dynamic changes in DNA methylation of stress-associated genes (OXTR, BDNF) after acute psychosocial stress. Translational Psychiatry, 2, e150. doi:10.1038/tp.2012.77.

    PubMed Central  PubMed  Google Scholar 

  • Vaccarino, V. (2010). Ischemic heart disease in women: Many questions, few facts. Circulation. Cardiovascular Quality and Outcomes, 3, 111–115.

    PubMed Central  PubMed  Google Scholar 

  • Vaccarino, V., Badimon, L., Corti, R., de Wit, C., Dorobantu, M., Hall, A., Koller, A., Marzilli, M., Pries, A., & Bugiardini, R. (2011). Ischemic heart disease in women: Are there sex differences in pathophysiology and risk factors? Position Paper from the Working Group on Coronary Pathophysiology & Microcirculation of the European Society of Cardiology. Cardiovascular Research, 90(1), 9–17.

    Google Scholar 

  • Vaccarino, V., Goldberg, J., Rooks, C., Shah, A. J., Veledar, E., Faber, T. L., Votaw, J. R., Forsberg, C. W., & Bremner, J. D. (2013a). Posttraumatic stress disorder and incidence of coronary heart disease: A twin study. Journal of the American College of Cardiology, 62(11), 970–978. doi:10.1016/j.jacc.2013.04.085.

    PubMed  Google Scholar 

  • Vaccarino, V., Badimon, L., Corti, R., de Wit, C., Dorobantu, M., Manfrini, O., Koller, A., Pries, A., Cenko, E., & Bugiardini, R. (2013b). Presentation, management, and outcomes of ischaemic heart disease in women. Nature Reviews. Cardiology, 10(9), 508–518.

    Google Scholar 

  • Vaccarino, V., Horwitz, R. I., Meehan, T. P., Petrillo, M. K., Radford, M. J., & Krumholz, H. M. (1998). Sex differences in mortality after myocardial infarction: Evidence for a sex-age interaction. Archives of Internal Medicine, 158, 2054–2062.

    PubMed  Google Scholar 

  • Vaccarino, V., Johnson, B. D., Sheps, D. S., Reis, S. E., Kelsey, S. F., Bittner, V., Rutledge, T., Shaw, L. J., Sopko, G., & Bairey Merz, C. N. (2007). Depression, inflammation, and incident cardiovascular disease in women with suspected coronary ischemia: The National Heart, Lung, and Blood Institute-sponsored WISE study. Journal of the American College of Cardiology, 50, 2044–2050.

    PubMed  Google Scholar 

  • Vaccarino, V., Krumholz, H. M., Yarzebski, J., Gore, J. M., & Goldberg, R. J. (2001). Sex differences in 2-year mortality after hospital discharge for myocardial infarction. Annals of Internal Medicine, 134, 173–181.

    PubMed  Google Scholar 

  • Vaccarino, V., Parsons, L., Every, N. R., Barron, H. V., & Krumholz, H. M. (1999). Sex-based differences in early mortality after myocardial infarction. National Registry of Myocardial Infarction 2 Participants. New England Journal of Medicine, 341, 217–225.

    PubMed  Google Scholar 

  • Vaccarino, V., Shah, A. J., Rooks, C., Ibeanu, I., Nye, J. A., Pimple, P., Salerno A., D’Marco L., Karohl C., Bremner J.D., Raggi, P. (2014). Sex differences in mental stress-induced myocardial ischemia in young survivors of an acute myocardial infarction. Psychosomatic Medicine, 76, 171–180.

    Google Scholar 

  • Vaccarino, V., Votaw, J., Faber, T., Veledar, E., Murrah, N. V., Jones, L. R., Zhao, J., Su, S., Goldberg, J., Raggi, J. P., Quyyumi, A. A., Sheps, D. S., & Bremner, J. D. (2009). Major depression and coronary flow reserve detected by positron emission tomography. Archives of Internal Medicine, 169, 1668–1676.

    PubMed Central  PubMed  Google Scholar 

  • von Kanel, R. (2004). Platelet hyperactivity in clinical depression and the beneficial effect of antidepressant drug treatment: How strong is the evidence? Acta Psychiatrica Scandinavica, 110, 163–177.

    Google Scholar 

  • von Kanel, R., Hepp, U., Buddeberg, C., Keel, M., Mica, L., Aschbacher, K., & Schnyder, U. (2006). Altered blood coagulation in patients with posttraumatic stress disorder. Psychosomatic Medicine, 68, 598–604.

    Google Scholar 

  • von Kanel, R., Hepp, U., Kraemer, B., Traber, R., Keel, M., Mica, L., & Schnyder, U. (2007). Evidence for low-grade systemic proinflammatory activity in patients with posttraumatic stress disorder. Journal of Psychiatric Research, 41, 744–752.

    Google Scholar 

  • von Kanel, R., Hepp, U., Traber, R., Kraemer, B., Mica, L., Keel, M., Mausbach, B. T., & Schnyder, U. (2008). Measures of endothelial dysfunction in plasma of patients with posttraumatic stress disorder. Psychiatry Research, 158, 363–373.

    Google Scholar 

  • von Mering, G. O., Arant, C. B., Wessel, T. R., McGorray, S. P., Bairey Merz, C. N., Sharaf, B. L., Smith, K. M., Olson, M. B., Johnson, B. D., Sopko, G., Handberg, E., Pepine, C. J., & Kerensky, R. A. (2004). Abnormal coronary vasomotion as a prognostic indicator of cardiovascular events in women: Results from the National Heart, Lung, and Blood Institute-Sponsored Women’s Ischemia Syndrome Evaluation (WISE). Circulation, 109, 722–725.

    Google Scholar 

  • Wassertheil-Smoller, S., Shumaker, S., Ockene, J., Talavera, G. A., Greenland, P., Cochrane, B., Robbins, J., Aragaki, A., & Dunbar-Jacob, J. (2004). Depression and cardiovascular sequelae in postmenopausal women: The women’s health initiative (WHI). Archives of Internal Medicine, 164, 289–298.

    PubMed  Google Scholar 

  • Wegman, H. L., & Stetler, C. (2009). A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood. Psychosomatic Medicine, 71, 805–812.

    PubMed  Google Scholar 

  • Weissman, M. M., Bland, R. C., Canino, G. J., Faravelli, C., Greenwald, S., Hwu, H. G., Joyce, P. R., Karam, E. G., Lee, C. K., Lellouch, J., Lepine, J. P., Newman, S. C., Rubio-Stipec, M., Wells, J. E., Wickramaratne, P. J., Wittchen, H., & Yeh, E. K. (1996). Cross-national epidemiology of major depression and bipolar disorder. JAMA, 276, 293–299.

    PubMed  Google Scholar 

  • Whang, W., Kubzansky, L. D., Kawachi, I., Rexrode, K. M., Kroenke, C. H., Glynn, R. J., Garan, H., & Albert, C. M. (2009). Depression and risk of sudden cardiac death and coronary heart disease in women: Results from the Nurses’ Health Study. Journal of the American College of Cardiology, 53, 950–958.

    PubMed Central  PubMed  Google Scholar 

  • Whooley, M. A., de Jonge, P., Vittinghoff, E., Otte, C., Moos, R., Carney, R. M., Ali, S., Dowray, S., Na, B., Feldman, M. D., Schiller, N. B., & Browner, W. S. (2008). Depressive symptoms, health behaviors, and risk of cardiovascular events in patients with coronary heart disease. Journal of the American Medical Association, 300, 2379–2388.

    PubMed Central  PubMed  Google Scholar 

  • Wong, C. C., Caspi, A., Williams, B., Craig, I. W., Houts, R., Ambler, A., Moffitt, T. E., & Mill, J. (2010). A longitudinal study of epigenetic variation in twins. Epigenetics, 5, 516–526.

    PubMed Central  PubMed  Google Scholar 

  • Wong, T. Y., Klein, R., Sharrett, A. R., Duncan, B. B., Couper, D. J., Tielsch, J. M., Klein, B. E., & Hubbard, L. D. (2002). Retinal arteriolar narrowing and risk of coronary heart disease in men and women. The Atherosclerosis Risk in Communities Study. Journal of the American Medical Association, 287, 1153–1159.

    PubMed  Google Scholar 

  • Wyman, L., Crum, R. M., & Celentano, D. (2012). Depressed mood and cause-specific mortality: A 40-year general community assessment. Annals of Epidemiology, 22, 638–643.

    PubMed Central  PubMed  Google Scholar 

  • Yehuda, R. (2002). Post-traumatic stress disorder. New England Journal of Medicine, 346, 108–114.

    PubMed  Google Scholar 

  • Zhao, J., Quyyumi, A. A., Patel, R., Zafari, A. M., Veledar, E., Onufrak, S., Shallenberger, L. H., Jones, L., & Vaccarino, V. (2009). Sex-specific association of depression and a haplotype in leukotriene A4 hydrolase gene. Psychosomatic Medicine, 71, 691–696.

    PubMed Central  PubMed  Google Scholar 

  • Zuidersma, M., Thombs, B. D., & de Jonge, P. (2011). Onset and recurrence of depression as predictors of cardiovascular prognosis in depressed acute coronary syndrome patients: A systematic review. Psychotherapy and Psychosomatics, 80, 227–237.

    PubMed  Google Scholar 

Download references

Acknowledgement 

The work presented in this review was supported by grants from the United States National Institutes of Health (R21HL093665, R21HL093665-01A1S1, R01 HL109413, P01 HL101398, K24HL077506 and K24 MH076955).

Author information

Authors and Affiliations

  1. Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA

    Viola Vaccarino M.D., Ph.D.

Authors
  1. Viola Vaccarino M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Viola Vaccarino M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Karolinska Institute, Stockholm, Sweden

    Kristina Orth-Gomér

  2. Department of Psychology, University of Miami, Coral Gables, Florida, USA

    Neil Schneiderman

  3. Department of Epidemiology, Rollins School of Public Health Emory University, Atlanta, Georgia, USA

    Viola Vaccarino

  4. Department of Psychosomatic Medicine, Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany

    Hans-Christian Deter

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Vaccarino, V. (2015). Psychosocial Risk Factors in Women: Special Reference to Depression and Posttraumatic Stress Disorder. In: Orth-Gomér, K., Schneiderman, N., Vaccarino, V., Deter, HC. (eds) Psychosocial Stress and Cardiovascular Disease in Women. Springer, Cham. https://doi.org/10.1007/978-3-319-09241-6_6

Download citation

Publish with us

Policies and ethics

Search

Navigation