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Matthew Menken, MD
Robert Wood Johnson Medical School Somerset, NJ

JAMA. 1992;268(2):197.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—A recent Editorial¹ that provides explanations for psychosocial influences on coronary heart disease mortality is a case study in late 20th-century medical reasoning in the United States. In brief, the author is keen to discover biomedical explanations for such psychosocial phenomena. A variety of neuroendocrine and autonomic nervous system influences are tendered as likely mechanisms. It is suggested that stressful life experiences might act on the heart to increase the risk of ventricular fibrillation (as if external agents of disease). If we are to communicate as effectively as possible with our patients, I suggest that we admit that just about anybody who has not graduated from a health-science institution would probably conclude that the association between psychosocial factors and heart disease is mediated by the mind.

Sadly, many neurologists, psychiatrists, and other physicians want to repeal the concept of mind, perhaps as a reaction to the influence . . . [Full Text PDF of this Article]

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