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Life adjustment postmyocardial infarction: determining predictive variables

M J Stern, L Pascale, A Ackerman

    Archives of Internal Medicine
    |December 1, 1977
    PubMed
    Summary
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    Post-myocardial infarction (MI) patients who are depressed show poor long-term adjustment and higher readmission rates. Denial may be associated with better rehabilitation outcomes, but women experience worse prognoses.

    Area of Science:

    • Cardiology
    • Psychology
    • Rehabilitation Medicine

    Background:

    • Myocardial infarction (MI) recovery involves psychosocial adjustment.
    • Previous pilot studies identified depressive and denial coping styles impacting rehabilitation.
    • Understanding these psychosocial factors is crucial for patient outcomes.

    Purpose of the Study:

    • To determine psychosocial adjustment in patients one year after myocardial infarction (MI).
    • To validate previous findings on depressive and denial groups' rehabilitation results.
    • To identify specific patient groups with poorer post-MI adjustment.

    Main Methods:

    • A cohort of 68 patients diagnosed with myocardial infarctions were followed for one year.
    • Patients were assessed for psychosocial adjustment, work status, sexual function, and hospital readmissions.

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  • Coping styles (depressive vs. denial) were evaluated based on prior pilot study criteria.

    • Main Results:

    • 70% of patients depressed post-MI remained depressed throughout the one-year follow-up.
    • Depressed patients had lower rates of return to work, impaired sexual function, and higher hospital readmission rates.
    • Patients in the denial group showed minimal psychosocial distress and comparable functioning to the general study population.

    Conclusions:

    • Persistent depression post-MI is linked to significantly poorer long-term psychosocial adjustment and clinical outcomes.
    • Denial, while not associated with distress, did not differentiate from the general functioning group.
    • Women post-MI faced greater challenges, with higher mortality and depression rates, potentially linked to Type A behavior.