Background: Although there is preliminary evidence that alexithymia may influence the course of coronary heart disease (CHD), there are no studies exploring attempts to modify alexithymic characteristics in cardiac patients. Method: Twenty post-myocardial infarction (MI) patients (19 men and 1 woman) were placed in a treatment group, which received weekly group psychotherapy for 4 months. Seventeen post-MI patients (16 men and 1 woman) were placed in a comparison group which received two educational sessions over a period of 1 month. All subjects completed the Toronto Alexithymia Scale (TAS) before the start of group therapy, at the end of the 4-month period, and in follow-up assessment after 6-month, 1-year, and 2-year intervals. Results: In the psychotherapy treatment group, there was a significant reduction in the mean TAS score following group therapy, which was maintained over the 2-year follow-up period. In the educational group, there were no significant changes in mean TAS scores between the initial testing and any of the follow-up intervals. On an individual basis, a decrease to a lower level of TAS scores occurred in a higher percentage of patients in the treatment group than in the educational group. Over the 2-year follow-up period, patients with decreased alexithymia following group therapy experienced fewer cardiac events (reinfarction, sudden cardiac death, or rehospitalization for rhythm disorder or severe angina) than patients whose alexithymia remained unchanged. Conclusions: The results indicate that group psychotherapy is able to decrease alexithymia and that for many patients this change can be maintained for at least 2 years. A reduction in the degree of alexithymia seems to influence favorably the clinical course of CHD.

Background: Despite increasing emphasis on using multiple methods to assess personality constructs in psychosomatic research, previous investigations of relations between alexithymia and type A behavior (TAB) have been limited by the use of single methods of measurement and almost no attempt to assess subcomponents of TAB. The aims of this study were to (1) evaluate levels of agreement between structured interview assessments of alexithymia, TAB, hostility, and time urgency and well-established self-report measures of these constructs, and (2) explore relations between alexithymia and TAB and its subcomponents in patients with coronary heart disease (CHD). Methods: 62 CHD patients were investigated 6 weeks after coronary angioplasty. Alexithymia was assessed with the Diagnostic Criteria for Psychosomatic Research (DCPR) and the 20-item Toronto Alexithymia Scale (TAS-20). TAB was assessed with the DCPR and the Short Form of the Jenkins Activity Survey Type A scale (JAS-SF). Time urgency was assessed with the DCPR and the Speed/Impatience scale of the Jenkins Activity Survey (JAS-S), and hostility was assessed with the DCPR and the Hostility subscale of the Revised Symptom Checklist-90 (SCL-HOS). Results: The DCPR classifications showed reasonably high levels of agreement with the TAS-20 and JAS-SF classifications of alexithymia and TAB, but lower levels of agreement in identifying patients with high hostility on the SCL-HOS and high time urgency on the JAS-S. Alexithymia measured by both the DCPR and the TAS-20 was unrelated to both self-report and structured interview measures of TAB, hostility, and time urgency. Conclusions: The DCPR is a suitable screening instrument for assessing alexithymia and TAB, although the two constructs are unrelated.

Depression is common in middle-aged men undergoing CABG and is an independent predictor of postoperative length of hospital stay and late perioperative complications.

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The prevalence and public health burden of chronic heart failure (CHF) in Europe is steadily increasing mainly caused by the ageing population and prolonged survival of CHF patients. Frequent hospitalizations, high morbidity and mortality rates, and enormous healthcare costs contribute to the health related burden. However, multidisciplinary frameworks that emphasize effective long-term management and the psychological needs of the patients are sparse. The present position paper endorsed by the European Association of Preventive Cardiology (EAPC) provides a comprehensive overview on the scientific evidence of psychosocial aspects of heart failure (HF). In order to synthesize newly available information and reinforce best medical practice, information was gathered via literature reviews and consultations of experts. It covers the evidence for aetiological and prospective psychosocial risk factors and major underlying psycho-biological mechanisms. The paper elucidates the need to include psycho social aspects in self-care concepts and critically resumes the current shortcomings of psychotherapeutic and psycho-pharmacological interventions. It also highlights the need for involvement of psychological support in device therapy for HF patients and finally calls for more, earlier and better palliative interventions in the final stage of HF progression.