Labbrozzi D, Carinci F, Nicolucci A, Bettinardi O, Zotti A M, Tognoni G
Laboratorio di Farmacologia Clinica ed epidemiologia, Consorzio Mario Negri Sud, Santa Maria Imbaro (CH).
G Ital Cardiol. 1996 Jan;26(1):85-106.
To provide a thorough psychological examination of patients with documented myocardial infarction (MI) enrolled in a multicenter randomized clinical trial (GISSI-2). The psychosocial variables examined include: state variables (anxiety, health-related fears, depression), psychophysical well-being in the three months preceding the acute event (depressive mood, impaired sense of well-being, perceived stress) and trait variables (Type-A Behavior (TAB), neuroticism, introversion/extroversion, social anxiety and feelings of guilt in interpersonal relationships).
A total of 2705 patients (12.5% females) admitted to 166 Italian Coronary Care Units.
Patients were administered the CBA-H, a standardized questionnaire with dichotomous responses (true/false), for a total of 152-item grouped into 16 scales. For each scale, the frequency of scores above cut-off values was computed and compared to patients' clinical and sociodemographic profile.
Over one third of all patients scored above the clinical cut-off for anxiety and health-related fears, and 15% showed a depressive pattern. Forty percent of patients reported depressive mood and a diminished sense of well-being in the past three months preceding MI, and more than half perceived themselves as stressed. About one third of the sample overtly exhibited TAB traits and half reported neuroticism scores in the clinical range. One half of our sample could be identified as extrovert, and 14% as introverted. Feelings of guilt and social anxiety were registered respectively in 40% and 12% of the sample. A worse psychological profile was associated to female gender, older age, lower education, living alone and a worse cardiac asset.
The study has documented the association between clinical, sociodemographic and psychological variables in a large sample of patients with IMA. While the impact of psychological variables upon patients' clinical outcome is to be evaluated, these data may be helpful in promoting the comprehensive and effective care of IMA patients.
对参与一项多中心随机临床试验（GISSI - 2）且有心肌梗死（MI）记录的患者进行全面的心理检查。所检查的社会心理变量包括：状态变量（焦虑、与健康相关的恐惧、抑郁）、急性事件前三个月的心理生理幸福感（抑郁情绪、幸福感受损、感知压力）以及特质变量（A型行为（TAB）、神经质、内向/外向、社交焦虑和人际关系中的内疚感）。
共有2705名患者（12.5%为女性）入住166家意大利冠心病监护病房。
对患者进行CBA - H问卷调查，这是一份具有二分法回答（是/否）的标准化问卷，共152个项目，分为16个量表。对于每个量表，计算得分高于临界值的频率，并与患者的临床和社会人口统计学特征进行比较。
超过三分之一的患者焦虑和与健康相关的恐惧得分高于临床临界值，15%表现出抑郁模式。40%的患者报告在心肌梗死前三个月有抑郁情绪且幸福感降低，超过一半的患者认为自己有压力。约三分之一的样本明显表现出A型行为特征，一半的患者报告神经质得分在临床范围内。样本中有一半可被认定为外向型，14%为内向型。分别有40%和12%的样本存在内疚感和社交焦虑。较差的心理状况与女性、年龄较大、教育程度较低、独居以及心脏状况较差有关。
该研究记录了大量心肌梗死患者临床、社会人口统计学和心理变量之间的关联。虽然心理变量对患者临床结局的影响有待评估，但这些数据可能有助于促进对心肌梗死患者的全面有效护理。
