Mental distress and treatment interventions in myocardial infarction patients: gender differences

Abstract

Introduction: Mental distress evident as symptoms of anxiety and depression, as well as distressed personality (Type D) is prevalent in myocardial infarction (MI) patients and is associated with poor prognosis and with worse patient-centered outcomes [1], [2]. However, studies examining mental distress among different types of treatment after MI are lacking. Gender specific psychological outcomes after revascularization procedures and conservative treatment in MI patients have not been widely studied. We aimed to evaluate gender specific differences in symptoms of depression, anxiety and Type D personality in MI patients after conservative treatment (CT), percutaneous transluminal coronary angioplasty (PTCA) and coronary bypass graft surgery (CABG). Methods: Consecutive acute MI patients after revascularization procedures (PTCA or CABG) or CT attending a cardiac rehabilitation program during the period from 2006 to 2010 were invited to participate in this cross-sectional study. In total 427 patients (72% men and 28% women; mean age 59±9 years) participated in the study. Within three days of admission to rehabilitation clinic all study patients were evaluated for demographic and clinical characteristics, for past and current diagnosis and treatments, for NYHA functional class, for symptoms of depression and anxiety and for Type D personality. Cardiovascular functional status was assessed according to the New York Heart Association (NYHA) functional class guidelines. Depressive and anxiety symptoms were assessed with the Hospital Anxiety and Depression scale (HADS). Patients with HADS scores of >7 were considered positive for symptoms of anxiety or depression. The type D personality construct was measured with the Type D Personality Scale (DS14). The DS14 consists of two 7-item subscales assessing negative...