Coronary heart disease: Treating the anxiety component

• 1.

  1. A number of studies have been undertaken demonstrating that psychiatric factors are of importance in coronary heart disease (CHD). Accordingly a double-blind comparison was made between two groups of patients who had suffered their first myocardial infarction, one group being treated with clorazepate and the other with placebo, for three months.

• 2.

  2. The patients made daily records of anginal attacks and other factors, and throughout the trial, the mean anginal attack rate and mean glyceryl trinitrate (GTN) requirement rates were less in those patients treated with clorazepate than in those treated with placebo. In the case of the GTN requirements, for the whole trial, the reduction was statistically significant in favour of clorazepate (p < 0.01).

• 3.

  3. On a number of other measures also, advantages were recorded for the patients treated with active medication. A new rating scale has been devised to assess psychiatric symptomatology in patients suffering from organic conditions which might otherwise cause symptoms which could be confused with the somatic items on established scales.