Psychosocial aspects of coronary artery disease related to military patients

Objective: Coronary artery disease (CAD) is a major cause of nontraumatic morbidity and mortality in military personnel. Most studies of the psychosocial impact of CAD have dealt with civilian populations. The purpose of this paper is to highlight differences between military and civilian populations with CAD in 4 areas: depression and anxiety, social support return to work, and stress. Method: A computerized literature search from 1985 to 1995 using the search terms ''stress,'' ''cardiovascular,'' ''cardiac,'' ''depression,'' ''military,'' ''anxiety'' and ''psychosocial'' was undertaken. Controlled and prospective studies of civilian patients were selected along with relevant studies involving military populations. Results: Unique characteristics of the military may be important factors in affecting the psychosocial outcome of military patients with CAD. These characteristics include a high level of denial of illness, strong social supports, a powerful military work ethic, and stressful situations unique to the military. Conclusions: Most studies of the psychosocial impact of CAD are based on civilian populations. A review of available studies suggests that little is known about how military patients adapt to CAD, particularly with regard to symptoms of depression and anxiety, social impairment, and rates of return to work. Studies in this area are needed regarding the psychosocial aspects of CAD in military populations.