Physician Investigator (Cl) Psychiatry, Mass General Research Institute

Psychiatrist Psychiatry, Massachusetts General Hospital

Professor of Psychiatry Harvard Medical School

MD Baylor College of Medicine 1999

acute coronary syndrome; anti-anxiety agents; antidepressive agents; anxiety; anxiety disorders; attempted suicide; behavior; chest pain; depression; depressive disorder major; heart diseases; inpatients; mental health; myocardial infarction; positive psychological interventions; psychosomatic medicine; suicidal ideation

Our research program focuses on the connections between mental health, behavior, and medical health in patients with heart disease and other chronic conditions.

We are interested in the impact of mood and anxiety disorders on cardiac health, and how different treatments for these disorders may impact quality of life and function. Depression and anxiety have been identified as risk factors for poor cardiac outcomes and death, independent of traditional cardiac risk factors such as high blood pressure, smoking or diabetes.

Unfortunately, depression and anxiety go unrecognized and untreated in the vast majority of patients with heart disease, despite the existence of safe and effective treatment. We have performed two randomized trials of care management for cardiac patients who have depression or anxiety disorders to determine whether having a care manager helps these patients to have better outcomes and better quality of life, and have examined the impact of psychiatric medications on cardiac health.

Also, we are increasingly interested in the role of positive thoughts and emotions in health. There is some suggestion that positive psychological states, like optimism, positive affect and self-efficacy in persons may independently predict superior health, yet these connections have not been closely studied in patients who have chronic or acute illnesses, like an acute coronary syndrome or type 2 diabetes.

We have adapted positive psychological exercises to this population to determine if such exercises can boost optimism, positive affect, and self-efficacy in persons with heart disease or type 2 diabetes. We are performing ongoing studies to better develop these exercises and to determine whether they may affect biology, health behaviors, and key cardiac outcomes. We are also working to adapt these positive psychological interventions to patients with diabetes and other medical illnesses.

Finally, we are exploring the use of positive psychological interventions for patients with serious mood disorders or recent suicide attempts, to determine whether cultivating positive states provides benefit in these populations as well. Optimism and other positive states have been linked to lower rates of suicidal thoughts and suicide attempts, and an approach that focuses on this aspect of mental health may be a novel and powerful approach.