[Personality and acute myocardial infarction: distinctive traits]

Aim of this study is to evaluate the presence of peculiar personality traits in patients with acute myocardial infarction as compared with normal subjects.

The Sixteen Personality Factor Questionnaire (16 PF) by Cattell (D form) is administered to 654 patients (558 males, 96 females) hospitalized for acute myocardial infarction in 16 coronary care units and to 398 normal subjects (261 males, 137 females). The diagnosis of myocardial infarction is made according to the presence of at least two of the following criteria: prolonged chest pain, elevation of CPK and CPKMB (twice the upper normal values), Q wave on the electrocardiogram. The normality of the control group is assured by specific exclusion criteria (cardiac or psychiatric disease, metabolic and endocrine disease, continued therapeutic treatment for any organic disease, or continued assumption of hypnotic and/or anxiolytic drugs).

In comparison with the control group, infarcted males result significantly different for factors C, N, Q1, Q4 (p < 0.001), for factors B, O (p < 0.01) and A, H, I (p < 0.05). Females with myocardial infarction differ significantly for factors C, O and I (p < 0.05). Four second-order factors is obtained from Cattell's 16 PF by factorial analysis: QI (anxiety), QII (extroversion), QIII (sensitivity), QIV (superego strength). The infarcted population shows statistically significant differences compared with controls: infarcted males show higher QI (p < 0.001) and lower QII and QIII (p < 0.05) while infarcted females have higher QI (p < 0.05).

These differences confirm that peculiar personality traits can be found in patients with acute myocardial infarction. In particular, infarcted males are emotionally unstable, anxious, rigid and depressed, and have problems in communication with others; infarcted females differ from the normal population for being emotionally unstable, anxious and for having a less flexible mental disposition. The higher anxiety level in patients with acute myocardial infarction may be related to the neuroticism that, in other studies, has been often found to be associated with cardiovascular disease. In conclusion, with respect to the normal population, patients with acute myocardial infarction appear to be anxious introverts, with conflictual personality.