David Shephard is founder of the Performance Partnership one of the leading providers of Personal Development Products in the World. He is a Master Trainer of NLP, Time Line Therapy and Hypnotherapy he is also a Doctor of esoteric studies. David recently participated in an academic study of the neuro-linguistic patterns in the work of best selling author Agatha Christie along with experts from the universities of London, Birmingham and Warwick . David was sought out by Dr Roland Kapferer, team leader of the project because of his mastery of linguistic patterns.

One of David's driving passions is the study of ancient spirituality and how in the modern world we could all benefit from a little ancient wisdom.

David believes in the subject so strongly that he has incorporated elements of spirituality into The Performance Partnerships seminars, he has also developed a very special course to teach ancient wisdom to modern people.

For more information visit: www.DavidShephard.com.

Coronary heart disease (CHD) is the leading cause of death and disability in the United States and in highly industrialized countries. Many modifiable psychosocial risk factors have been identified and can affect the course of cardiac illness. These include the negative emotional states of depression, anxiety, stress, anger/hostility, and social isolation. Anxiety has been found to increase the risk of developing CHD in healthy subjects and can lead to worsening of existing CHD. There is much overlap and confusion throughout the research literature between what authors define as anxiety, stress, Type A behavioral pattern, and anger/hostility.There is a need for better screening within the practice of cardiology for these psychosocial risk factors to ensure better integration of mental health services. Established screening tools such as the Beck Anxiety Inventory, Patient Health Questionnaire-9, Zung Self-Rating Anxiety Scale, and the Hamilton Anxiety Scale are described and compared with the newer Screening Tool for Psychologic Distress as part of the initial work-up of every cardiac patient. Recommendations are made using the author's Anxiety Treatment Algorithm regarding when to refer to a mental health professional along with how to reduce stigma and provide more integrated care. The diagnosis and treatment of anxiety disorders is reviewed, with attention to selective serotonin reuptake inhibitors, benzodiazepines, cognitive-behavioral therapy, stress reduction, and behavioral medicine group programs. These group programs are recommended because they help to overcome social isolation and counsel patients on how to adapt to a healthy lifestyle. Better clinical outcome research is needed that specifically addresses the question of whether the treatment of anxiety and anxiety disorders can affect the course of cardiac illness.

Cardiol Rev. 2009 Jan-Feb;17(1):36-43. Janeway D. Department of Psychiatry, New York Medical College, Valhalla, NY, USA. DavidJaneway@aol.com