[Biographical analysis and myocardial infarct: a study of myocardial infarction patients and 2 reference groups].

In a retrospective case-referent study, 105 male myocardial infarction patients (age: 35-69), 105 hospital referents, and 105 neighbourhood referents, all of the same age, were interviewed with respect to exposure to some psychosocial risk indicators in their lives. These indicators include: Type A coronary-prone behavior pattern; the prevalence of stressful changes in childhood and adolescence, work and career, and family and social life; the syndrome of vital exhaustion and depression, which may precede myocardial infarction. The central question of this study is in what manner and in what connection these risk indicators may affect the lives of myocardial infarction patients. The results indicate that in general the prevalence of Type A behavior is twice as high in myocardial infarction patients as in both referent groups. On the other hand, this difference only reaches significance in younger patients (N = 30; age: 35-44). The prevalence of stressful life changes in myocardial infarction patients is characterized in particular by both the cohort-specific and the "non-normative" nature of these life changes. In young patients (N = 15; age: 35-39), all of whom but one are Type A, only some life changes associated with work and career occur significantly more often. In older patients (N = 30; age: 50-54, and 65-69) the latter problems are replaced by and intermingled with (chronic) conflicts in family and social life, that occur significantly more often. The myocardial infarction patients score significantly higher on the syndrome of vital exhaustion and depression than both referent groups. This syndrome is probably specific to myocardial infarction patients, and appears-unlike Type A behavior-not to be dependent on age. The results are discussed in terms of an "attributional" model that might explain the development of vital exhaustion and depression in the biography of myocardial infarction patients.