On a sunny summer evening on Monday 24^th June 2024 Professor David Thompson gave a Professorial Lecture in the Council Chamber, Lanyon Building, QUB. David is Professor of Nursing in the School of Nursing and Midwifery at QUB. He is also a visiting and honorary Professor at universities in the UK, Ireland, China and Australia, and Distinguished Professor at Anhui Medical University in China. The title of the lecture was 'Matters of the Heart and Mind: Less Talk, More Action.' In attendance were family members and friends who joined colleagues from education, health and social care, and third sector organisations across Northern Ireland.

Though the link between the heart and mind has been postulated for centuries, it is only very recently that heart disease and mental health disorders have been recognised as common companions. Both conditions are prevalent, burdensome, and costly: heart disease as the leading cause of death worldwide and mental health disorders, especially depression, as the leading causes of disability worldwide. Many people have both and there is a bi-directional relationship between them. This burden is compounded by other common comorbidities, especially diabetes. David highlighted that though the link between heart and mental health was increasingly recognised, much more needed to be done to address it.

As good heart and mental health are integral to overall health and wellbeing, David described how he has spent much of his clinical and academic career studying the sources, patterns and impact of anxiety and depression among patients and their loved ones after a cardiac event, and developing and testing interventions and outcome measures designed to aid rehabilitation and recovery and enhance quality of life. He emphasized the importance of a detailed assessment of psychological state and how this can inform the choice of intervention for people with heart disease and mental health issues, taking into account preferences, personal circumstances and health literacy. As mental health disorders reduce adherence to treatment and serve as a barrier to behaviour change and the adoption of a healthy lifestyle, interventions should be needs-led, menu-driven and evidence-based.

Psychosocial interventions, including ‘talking therapies’, are effective but often not used. David presented an overview of these interventions and their evidence base and suggested they should be integral to cardiac care, rehabilitation and secondary prevention, as recommended in clinical guidelines. He suggested that though they are complex interventions they are often poorly conceptualized, described or reported, that they vary in terms of type, duration, content or mode of delivery, and that the focus should shift to personalised, digital heath delivery systems.

David concluded that as the heart and mind are inextricably linked, a multidimensional (biopsychosocial) approach is needed to better understand this link and to underpin and practise truly patient-centred care. Although international and national guidelines include psychosocial risk factors, assessment and intervention, implementation of guideline recommendations is lagging and and many health care professionals and the public lack knowledge of psychosocial issues. It is time we treated the heart and the mind together. Ample evidence is available but often not used in routine clinical practice. Simply put, we need less talk, more action.

Below are a selection of Professor Thompson's Publications:

• Laranjo L, Lanas F, Sun MC, Chen DA, Hynes L, Imran TF, Kazi DS, Kengne AP, Komiyama M, Kuwabara M, Lim J, Perel P, Piñeiro DJ, Ponte-Negretti CI, Séverin T, Thompson DR, Tokgözoğlu L, Yan LL, Chow CK. World Heart Federation Roadmap for Secondary Prevention of Cardiovascular Disease: 2023 Update. Global Heart 2024;19(1):8.  https://doi.org/10.5334/gh.1278    

• Clark AM, Sousa BJ, Ski CF, Redfern J, Neubeck L, Allana S, Peart A, MacDougall D, Thompson DR. Main mechanisms of remote monitoring programs for cardiac rehabilitation and secondary prevention: a systematic review. Journal of Cardiopulmonary Rehabilitation and Prevention 2023;43(6):412-418 DOI: 10.1097/HCR.0000000000000802 

• Le Grande MR, Murphy BM, Rogerson MC, Ski CF, Amerena J, Smith JA, Hoover V, Alvarenga ME, Higgins RO, Thompson DR, Jackson AC. Development of a short form of the Cardiac Distress Inventory. BMC Cardiovascular Disorders 2023;23(1):408   https://doi.org/10.1186/s12872-023-03439-w 

• Dibben G, Faulkner J, Oldridge N, Rees K, Thompson DR, Zwisler AD, Taylor RS. Exercise-based cardiac rehabilitation for coronary heart disease – an updated Cochrane systematic review and meta-analysis. European Heart Journal 2023;44(6):452-469  https://doi.org/10.1093/eurheartj/ehac747 

• Eide LSP, Fridlund B, Hufthammer KO, Haaverstad R, Packer EJS, Ranhoff AH, Thompson DR, Norekvål T. The CARDELIR investigators. Anxiety and depression in patients aged 80 years and older following aortic valve therapy. A six-month follow-up study. Aging Clinical and Experimental Research 2023;35(11):2463-2470  https://doi.org/10.1007/s40520-023-02541-5 

• Thompson DR, Pedersen SS. Psychosocial assessment and psychological interventions following a cardiac event. Heart 2023;109(5):405-410   https://doi.org/10.1136/heartjnl-2022-321607