Table 1 Inclusion/exclusion criteria

Inclusion criteria for screening procedure

1. Patients of any gender

2. Ages 18–85 years

3. Hospitalized in a cardiology or cardiothoracic surgery department with a CHD diagnosis documented as:

   (a) coronary angiography (> 50% stenosis in ≥ 1 major coronary vessel)

   (b) and/or confirmed acute coronary syndrome

   (c) and/or history of coronary revascularization (percutaneous intervention or coronary artery bypass surgery)

4. Ability to speak, read and understand German

5. HADS > 12 and/or PSS-4 > 5

6. Signed informed consent to screening procedure

Inclusion criteria for main trial

1. HADS > 12 and/or score on PSS-4 > 5

2. > = 1 insufficiently controlled cardiac risk factor as defined as:

   (a) Hypertension with blood pressure > = 140/90 mmHg

   (b) Hyperlipidemia with LDL-cholesterol > = 70 mg/dl

   (c) Current smoking

   (d) Diabetes with HbA1c > = 7.0%

   (e) Physical inactivity: self-report of < 150 min. of moderate or < 75 min. of vigorous physical activity per week

3. Written informed consent for study participation

Exclusion criteria

1. Severe cognitive impairment, defined as known dementia or inability to follow the assessment instructions

2. Communication difficulties (e.g. hard of hearing, aphasia)

3. Acute or severely disabling non-cardiac disease with estimated survival < 1 year

4. Need for more specialized cardiac or mental health interventions or structured rehabilitation programs such as

   (a) recurrent ACS or coronary surgery after the index hospitalization

   (b) severe mental disorders (e.g. acute psychoses) or addiction (except tobacco)

5. Participation in another treatment trial likely to affect the outcomes of interest or interfering with the trial procedures