Psychosocial Stress and Ischaemic Heart Disease: A Rejoinder to Boman's Response

Abstract

This reply focuses on the two main areas of Dr Boman's critique. First, his interpretation of additional literature not cited in the original review is discussed. I would argue that most of this literature is retrospective and involves unsophisticated analyses: causal interpretations are not easily supported by the studies he cites. Secondly, conclusions based on the clinical evidence of the ‘Smith’ case are also poorly founded; this is discussed in some detail with some attention given to the severity of the war related stressor and the time and nature of the patient's emotional response to it.

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