[Denial and coronary disease. A reconsideration of the denial mechanism in psychosomatic diseases and particularly in coronary disease].

Recent research has shown that patients with life-threatening illnesses have improved chances of survival and enhanced abilities to manage situational anxiety and depression if, instead of recognizing the seriousness of their illness, they employ the psychological defense mechanism of denial. Denial as a coping style provides indeed marked benefits for the patient, at least during acute hospital recovery, but seems to be possibly maladaptative in the long run after hospital discharge. The present study is an attempts to review the different findings related to the use of denial by the coronary patient. The concept and its use are re-examined from the very different standpoints of the patient, the cardiologist and the psychologist, in a psychodynamic, a systemic and a psychosomatic perspective. Even if clinically meaningful, denial is also revisited through both the ethical and the epistemological approaches.