Multidimensional psychosocial screening in routine cardiac care: preliminary findings from a cross-sectional survey

Q: What are the key findings of this study?

Multidimensional psychosocial screening identified pronounced heart-focused anxiety (HAF-17 21.1±10.6) and perceived stress (52.1%) despite low depression (PHQ-9 5.0±4.7) and anxiety (GAD-7 3.5±4.4).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cardiovascular disease / routine cardiology care patients (n=62). Intervention: Multidimensional psychosocial screening. Primary outcome: Prevalence and interrelationships of multidimensional psychosocial symptoms (depressive symptoms [PHQ-9], generalized anxiety [GAD-7], heart-focused anxiety [HAF-17], perceived stress, sleep disturbances [JSS], loneliness [UCLA-3], resilient coping [BRCS], life satisfaction) and psychocardiology service awareness/interest (p=<0.05).

Q: What does this research mean for the field?

Multidimensional psychosocial screening in routine cardiology care reveals pronounced heart-focused anxiety and perceived stress despite low levels of depression and generalized anxiety. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate multidimensional psychosocial distress—including depression, general anxiety, heart-focused anxiety, perceived stress, and sleep disturbances—and assess awareness of psychocardiology services in routine cardiac care.

Omar Hahad; Jasmin Ghaemi Kerahrodi; Leila I. Pasha; Michael Molitor; Matthias Michal; Jonas Tesarz; P H I L I P Lurz; Julia Lurz

doi:10.1007/s00059-026-05382-w

June 24, 2026HerzOpen Access

Multidimensional psychosocial screening in routine cardiac care: preliminary findings from a cross-sectional survey

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Key result

Psychosocial screening reveals ~52% perceived stress and heart-focused anxiety despite low general anxiety.

P<0.05
n=62

Why the study?

Psychological distress is common in cardiovascular disease, but despite ESC recommendations on mental health in cardiology care, psychosocial assessment remains inconsistently implemented in routine clinical practice.

Key Points

To evaluate multidimensional psychosocial distress—including depression, general anxiety, heart-focused anxiety, perceived stress, and sleep disturbances—and assess awareness of psychocardiology services in routine cardiac care.
Cross-sectional survey of 62 patients undergoing routine cardiac care at a tertiary cardiology department (61.4% male, 69.3% aged ≥61 years, 77.0% with known heart disease).
Standardized self-report tools assessed depressive symptoms (PHQ-9), generalized anxiety (GAD-7), heart-focused anxiety (HAF-17), sleep disturbances (Jenkins Sleep Scale), coping resilience (BRCS), loneliness (UCLA-3), and service awareness.
Depressive symptoms (mean PHQ-9 5.0 ± 4.7) and generalized anxiety (mean GAD-7 3.5 ± 4.4) were low, whereas heart-focused anxiety was pronounced (mean HAF-17 21.1 ± 10.6), perceived stress was present in 52.1% (43.8% mild, 8.3% severe), and sleep disturbances averaged 6.5 ± 5.5 on the JSS.
Heart-focused anxiety correlated with depressive symptoms (ρ = 0.513, p < 0.001), anxiety (ρ = 0.466, p < 0.001), sleep disturbances (ρ = 0.306, p = 0.022), and loneliness (ρ = 0.282, p = 0.037), but not with life satisfaction (ρ = 0.002, p = 0.99).
Only 7.0% of patients were aware of psychocardiology services prior to screening, but 56.2% reported interest in using such support (8.8% yes, 47.4% maybe).

Study Design

Type

Cross-Sectional (n=62)

Multicenter

No

Structured PICO

P

Population

62 predominantly older adults (69.3% aged ≥61 years, 38.6% female, 77.0% with known heart disease) undergoing routine outpatient or inpatient care at a tertiary cardiology department in Germany.

E

Exposure

Anonymous paper-based multidimensional psychosocial screening during routine care using standardized instruments: PHQ-9 (depressive symptoms), GAD-7 (generalized anxiety), HAF-17 (heart-focused anxiety), Jenkins Sleep Scale (JSS), Brief Resilient Coping Scale (BRCS), UCLA-3 (loneliness), single-item perceived stress, life satisfaction, social support, medication adherence, and awareness/interest in psychocardiology services.

O

Outcome

Prevalence, distribution, and Spearman rank interrelationships of psychosocial symptoms and resources (PHQ-9, GAD-7, HAF-17, JSS, UCLA-3, BRCS, perceived stress, social support, life satisfaction, medication adherence) as well as patient awareness of and interest in psychocardiology services.patient reported

Main Result

p-value: p=<0.05

Limitations

Small sample size (n=62) in a single-center tertiary care setting limiting generalizability and precluding robust multivariable analyses
Cross-sectional design limiting conclusions about causality and directions of relationships
Use of self-report measures which may be influenced by reporting bias and do not replace structured clinical interviews
Anonymous design precluded linkage with detailed clinical information (specific cardiac diagnoses, disease severity, cardiac function, comorbidities, or treatment course)
Non-tracked distribution process and convenience sampling prevented calculation of response rates and may have introduced selection bias
Unstandardized timing of questionnaire completion across different clinical phases
Relatively small sample size (n=62) in a single-center tertiary care setting
Cross-sectional design limits ability to draw conclusions about causality and directionality
Self-report measures may be influenced by reporting bias and do not replace structured clinical interviews
Anonymous design precluded linkage with detailed clinical data (specific cardiac diagnoses, severity, function, comorbidities, or treatment course)
Non-tracked distribution and voluntary convenience sampling prevented calculation of response rates and may have introduced selection bias
Unstandardized timing of questionnaire completion during routine clinical workflow

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Implication

Multidimensional psychosocial screening in routine cardiology care uncovers substantial heart-focused anxiety, perceived stress, and sleep disturbances that standard depression and generalized anxiety screens miss, alongside high patient openness (56.2%) to psychocardiological support despite low prior awareness (7.0%).

Abstract

BACKGROUND: Psychological distress is common among patients with cardiovascular disease. While European Society of Cardiology (ESC) position papers highlight the relevance of mental health in cardiology care, psychosocial assessment remains inconsistently implemented in routine clinical practice. METHODS: In this preliminary cross-sectional survey, patients attending a tertiary cardiology department completed an anonymous multidimensional psychosocial screening during routine care. Standardized instruments assessed depressive symptoms (PHQ-9), generalized anxiety (GAD-7), heart-focused anxiety (HAF-17), sleep disturbances (Jenkins Sleep Scale), resilient coping (BRCS), loneliness (UCLA-3), life satisfaction, perceived stress, social support, medication adherence, and awareness of psychocardiology services. RESULTS: A total of 62 patients were included. Overall levels of depressive and generalized anxiety symptoms were low (PHQ‑9 5.0 ± 4.7; GAD‑7 3.5 ± 4.4), while heart-focused anxiety was more pronounced (HAF-17 21.1 ± 10.6). Perceived stress was reported by 52.1% of participants (43.8% mild, 8.3% severe), and sleep disturbances were frequent (JSS 6.5 ± 5.5). Heart-focused anxiety showed consistent associations with general anxiety, depressive symptoms, stress, and sleep problems (all p < 0.05), but was not related to life satisfaction (p = 0.99). Life satisfaction correlated more strongly with general emotional well-being than with cardiac-specific fears. Despite limited prior awareness of psychocardiology services (7.0% aware), a substantial proportion of patients reported interest in receiving psychosocial support in a cardiology setting (8.8% yes and 47.4% maybe). CONCLUSION: Psychosocial burden in cardiology patients may extend beyond depression and generalized anxiety. Cardiac-specific fears, stress, and sleep disturbances are prominent but frequently underrecognized domains that may be overlooked by unidimensional screening approaches. A significant proportion of patients were unaware of existing psychocardiology services, suggesting a gap between recommended mental health integration and routine cardiology care. Multidimensional screening may facilitate more targeted identification of patients who could benefit from integrated psychocardiological care.

Discussion

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Cite This Study

Hahad et al. (2026) conducted a cross-sectional in Cardiovascular disease / routine cardiology care patients (n=62). Multidimensional psychosocial screening was evaluated on Prevalence and interrelationships of multidimensional psychosocial symptoms (depressive symptoms [PHQ-9], generalized anxiety [GAD-7], heart-focused anxiety [HAF-17], perceived stress, sleep disturbances [JSS], loneliness [UCLA-3], resilient coping [BRCS], life satisfaction) and psychocardiology service awareness/interest (p=<0.05). Multidimensional psychosocial screening identified pronounced heart-focused anxiety (HAF-17 21.1±10.6) and perceived stress (52.1%) despite low depression (PHQ-9 5.0±4.7) and anxiety (GAD-7 3.5±4.4).

synapsesocial.com/papers/6a3d91bf408ebb922448b152 https://doi.org/10.1007/s00059-026-05382-w

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Multidimensional psychosocial screening in routine cardiac care: preliminary findings from a cross-sectional survey

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Multidimensional psychosocial screening in routine cardiac care: preliminary findings from a cross-sectional survey

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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