High levels of self-perceived stressful life circumstances and psychological distress approached statistical significance as a risk factor for cardiovascular events after myocardial infarction.
Cohort (n=61)
Does psychological distress predict cardiovascular events in patients with recent myocardial infarction undergoing cardiac rehabilitation?
Psychological distress and subclinical psychiatric syndromes are highly prevalent in cardiac rehabilitation patients and may serve as risk factors for future cardiovascular events.
BACKGROUND: While there has been an upsurge of interest in the psychiatric correlates of myocardial infarction, little is known about the presence of psychological distress in the setting of cardiac rehabilitation. METHODS: A consecutive series of 61 patients with recent myocardial infarction who participated in a cardiac rehabilitation program was evaluated by means of both observer-rated (DSM and DCPR) and self-rated (Psychosocial Index) methods. A follow-up of this patient population was undertaken (median = 2 years). Survival analysis was used to characterize the clinical course of patients. RESULTS: Twenty percent of patients had a DSM-IV diagnosis (in half of the cases minor depression). An additional 30% of patients presented with a DCPR cluster, such as type A behavior and irritable mood. Only high levels of self-perceived stressful life circumstances and psychological distress approached statistical significance as a psychological risk factor for cardiovascular events after myocardial infarction. CONCLUSIONS: Psychological evaluation of patients undergoing cardiac rehabilitation needs to incorporate both clinical (DSM) and subclinical (DCPR) methods of classification. Type A behavior was present in about a quarter of patients and can be studied in specific subgroups of cardiovascular patients defined by DCPR.
Rafanelli et al. (Wed,) conducted a cohort in Recent myocardial infarction (n=61). Psychological distress and stressful life circumstances was evaluated on Cardiovascular events. High levels of self-perceived stressful life circumstances and psychological distress approached statistical significance as a risk factor for cardiovascular events after myocardial infarction.