Levenson J L, Kay R, Monteferrante J, Herman M V
Psychosom Med. 1984 Jan-Feb;46(1):25-32. doi: 10.1097/00006842-198401000-00005.
Denial may be prognostically favorable in patients with acute myocardial infarction. We analyzed the significance of denial in 26 patients referred to a tertiary care center for advanced therapy of unstable angina. Group A comprised 14 patients characterized as deniers on the Hackett--Cassem Denial Scale. Group B comprised 12 nondeniers. There were no differences between groups in multiple baseline social and demographic characteristics, cardiac history, or risk factors. Similarly, there were no differences in the number of diseased vessels or left ventricular function in those patients catheterized (11 Group A patients, 9 Group B patients). Group B, however, had a longer hospitalization until medically stabilized (pain-free for 36 hr) than Group A (5.9 +/- 3.6 days vs. 3.0 +/- 1.6 days; p = 0.02) despite similar treatment regimens. There were no significant differences in incidence of myocardial infarction or need for surgery. There were two deaths--both in Group B patients. We conclude that denial independently predicts rapid medical stabilization in unstable angina patients. Whether it predicts better longterm outcome requires further study.
否认态度在急性心肌梗死患者中可能预后良好。我们分析了26例因不稳定型心绞痛转诊至三级医疗中心接受高级治疗的患者中否认态度的意义。A组包括14例在哈克特 - 卡森否认量表上被判定为否认者的患者。B组包括12例非否认者。两组在多项基线社会和人口统计学特征、心脏病史或危险因素方面无差异。同样，在接受导管插入术的患者中（A组11例患者，B组9例患者），病变血管数量或左心室功能也无差异。然而，尽管治疗方案相似，但B组在病情医学稳定（无痛36小时）之前的住院时间比A组长（5.9±3.6天对3.0±1.6天；p = 0.02）。心肌梗死发生率或手术需求方面无显著差异。有两例死亡——均为B组患者。我们得出结论，否认态度可独立预测不稳定型心绞痛患者的快速医学稳定。它是否能预测更好的长期预后需要进一步研究。
