The relationship between mental disorders and physical severities in patients with acute myocardial infarction.

We studied the relationship between the mental disorders and the mental severities of 163 patients with acute myocardial infarction (AMI), who were admitted to the CCU (Coronary Care Unit) of Nippon Medical School Hospital during the past 2 years. Their mental disorders were diagnosed by psychiatrists, and the relationship between their physical severities according to Killip's classification and their mental severities was investigated. Based on these studies, the authors described the way to manage AMI patients in a CCU, especially from a psychiatric point of view. 1) About 64% of all the patients showed some mental disorders, and many of them were in a state of anxiety or depression. In most of the cases their mental severities were considered to be mild or moderate. 2) We found some correlation between physical severities according to Killip's classification and mental severities (r = 0.3061, p less than 0.005). Many patients with grade I of Killip's classification showed a normal or mild severity, and many with grade II had a mild or moderate severity. About one half of the patients with grades III and IV showed moderate and severe severities, respectively. 3) About 26% of the subjects were in need of psychotropic medication. 4) About 10% of the subjects showed disorientation or cloudy consciousness. The mental severity of patients with an acute lidocaine intoxication was severe. These results showed that there was a significant correlation between physical severity according to Killip's classification and mental severity of AMI patients in the CCU. Patients whose physical severity was not so great showed comparatively mild mental disorders. As Killip's grade of physical severity progressed, mental disorder became more severe.