Table of Contents
Cardiovascular Psychiatry and Neurology
Volume 2009, Article ID 791017, 8 pages

Cardiovascular Disease and Psychiatric Comorbidity: The Potential Role of Perseverative Cognition

Department of Psychology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0109, USA

Received 16 March 2009; Accepted 1 June 2009

Academic Editor: Hari Manev

Copyright © 2009 Britta A. Larsen and Nicholas J. S. Christenfeld. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The high comorbidity between psychiatric disorders and cardiovascular disease has received increasing attention, yet little is known about the processes linking the two. One plausible contributing mechanism is the tendency of those with psychiatric disorders to ruminate on stressful events. This phenomenon, sometimes called perseverative cognition, can extend the psychological and physiological effects of stress, which could contribute to cardiovascular disease etiology. In this paper, we discuss the potential role of perseverative cognition in mediating the relationship between psychiatric illness and cardiovascular disease. Rumination can delay physiological recovery from acute stress, which in turn has been found to predict future cardiovascular health. This delayed recovery could act as a mechanism in the longitudinal link between worry and cardiovascular health. The cognitive inflexibility that characterizes mood and anxiety disorders may then contribute to disease not by producing greater reactivity, but instead through extending activation, increasing the risks for cardiovascular damage.