Distress or Illness? a Study of Psychological Symptoms after Myocardial Infarction

Abstract

Three groups of patients were identified during a study of men who had recently suffered an acute myocardial infarction: those with psychiatric morbidity antedating the infarction and those with no significant psychopathology. Compared to the other two groups, patients with psychiatric morbidity before the infarction were more likely to be unmarried, unemployed and to have received previous psychiatric treatment. They also obtained higher scores for neuroticism and psychoticism on personality assessment. Patients whose symptoms have been precipitated by the infarction resembled the psychologically healthy group with regard to their demographic characteristics and personality. Their symptoms tended to be transient, improving without special psychiatric treatment.

Depression in chronic medical illness: The case of coronary heart disease

“…Patients after MI are less likely to return to work within six months of their event (Lloyd & Cawley, 1983) and report an overall poorer quality of life (Stewart et al, 1989). Similar findings have been reported for patients undergoing CABG, where depression assessed immediately before the surgery is associated with continued pain, depression, and failure to return to normal or routine activities (Burg, Benedetto, Rosenberg & Soufer, 2000a).…”

The Influence of Anxiety and Depression on Outcomes of Patients With Coronary Artery Disease

“…70,71 In addition, depressed patients after MI are more likely to report being more anxious or stressed than their counterparts without depression. 72 The evidence that depression affects post-MI prognosis is growing. Those with post-MI depression are at increased risk for subsequent cardiac events, including reinfarction and rehospitalization, as compared with patients after MI without depression.…”

Psychosocial aspects of surviving sudden cardiac death

“…It is characterized by the onset of a maladaptive reaction within 3 months of a stressor and is accompanied by the assumption that the disturbance will eventually disappear or lessen when the stressor ceases or when a new level of adaptation is reached. This seems to be especially true of some patients without prior psychiatric morbidity (Lloyd and Cawley, 1983). At times the depression begins and leaves slowly, outlasting the patient's apprehensions.…”

“…Occasionally, a major depression arises, particularly in patients with previous psychiatric morbidity. (Lloyd and Cawley, 1983). It is chamcterized by prominent and relatively persistent dysphoric moods along with the presence of at least four of the following eight symptoms lasting at least two weeks: appetite disturbance and weight change, sleep disturbance, psychomotor change, anhedonia or loss of libido, loss of energy, feelings of worthlessness or excessive guilt or self reproach, decreased concentration or indecisiveness, and suicidal ideation or attempt or recurrent thoughts of death.…”