Psychosocial Aspects of Chronic Illness: Direct and Indirect Associations with Ischemic Heart Disease Mortality

Every aspect of human health and disease bears the imprint of psychosocial processes and the variety of methodologies and endpoints considered in the literature lends confidence to the first statement.

Abstract

Every aspect of human health and disease bears the imprint of psychosocial processes. Although this is a rather strongly worded statement, it can, I believe, stand up to the hardest scrutiny at both empirical and conceptual levels. The facts leading to this conclusion have been stated by many. Psychosocial factors are related to exposure to harmful agents or environments, to the practice of risk-increasing or decreasing behaviors, to increased susceptibility to particular conditions, progression of disease, help-seeking behavior, access to medical care, adherence to and effect of medical treatments, recovery from serious conditions, and a wide range of other outcomes. Although the quality of the evidence varies widely, the variety of methodologies and endpoints considered in the literature lends confidence to my first statement.