Psychotherapy and Psychosomatics
Regular Article
Prodromal Symptoms in Myocardial InfarctionOttolini F.a · Modena M.G.b · Rigatelli M.aDepartments of aPsychiatry and Mental Health and bCardiology, University of Modena and Reggio Emilia, Modena, Italy
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Published online: August 10, 2005
Issue release date: August 2005
Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 5
ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)
For additional information: https://www.karger.com/PPS
Abstract
Background: Little is known about the prodromal phase of myocardial infarction (MI). The aim of this study was to explore this phase with methodologies which have been standardized in affective disorders. The psychological evaluation of patients with MI diagnosis is currently based on DSM-IV criteria. An alternative diagnostic and conceptual framework has been proposed by an international group of psychosomatic investigators. In this study, we are going to compare these new criteria, i.e. the Diagnostic Criteria for Psychosomatic Research (DCPR), with DSM-IV in a population where a high prevalence of psychological problems is expected. Methods: A semistructured research interview based on Paykel’s Clinical Interview for Depression for eliciting prodromal symptoms was administered to a consecutive series of 92 patients with a first episode MI diagnosis. Two interviews for the evaluation of psychological problems were administered according to DSM-IV and DCPR criteria. Results: Most of the patients reported prodromal symptoms. Irritability, depressed mood and somatic anxiety were the most common prodromal symptoms. The results also show that the number of DCPR diagnoses was higher than the number of DSM-IV diagnoses. At least one DCPR diagnosis was found in all patients, whereas at least one DSM-IV diagnosis was present in 42 (46%) patients. Conclusions: The prodromal phase of MI was found to be characterized by prodromal symptoms of affective type. The joint use of DSM-IV and DCPR criteria was found to improve the identification of psychological factors which could affect this phase. The results should alert the physician to the fact that patients presenting with irritability, depressed mood (including demoralization), anxiety and insomnia may be at risk of developing coronary artery disease.
© 2005 S. Karger AG, Basel
Related Articles:
References
- Carney RM, Freedland KE, Jaffe AS, Frasure-Smith N, Lesperance F, Sheps DS, Glassman AH, O’Connor CM, Blumenthal JA, Kaufmann PG, Czajkowski SM: Depression as a risk factor for post-MI mortality. J Am Coll Cardiol 2004;44:472.
- Bankier B, Littman AB: Psychiatric disorder and coronary heart disease in women. Psychother Psychosom 2002;71:133–140.
- Kop WJ, Appels A, Mendes de Leon CF, Bar FW: The relationship between severity of coronary artery disease and vital exhaustion. J Psychosom Res 1996;40:397–405.
- Appels A, Kop WJ, Schounten E: The nature of the depressive symptomatology preceding myocardial infarction. Behav Med 2000;26:86–89.
- Schuitemaker GE, Dinant GJ, Van Der Pol GA, Verhelst AF, Appels A: Vital exhaustion as a risk indicator for first stroke. Psychosomatics 2004;45:114–118.
- Anda RF, Williamson DF, Jones D, Macera C, Eaker E, Glassman AH, Marks J: Depressed affects, hopelessness and risk of ischaemic disease in cohort of US adults. Epidemiology 1993;4:285–294.
- Jenkins CD: While there is hope, there’s life. Psychosom Med 1996;58:122–124.
- Everson SA, Goldberg DE, Kaplan GA, Cohen RD, Pukkala E, Tuomiletho J, Salonen JT: Hopelessness and risk of mortality and incidence of myocardial infarction. Psychosom Med 1996;58:113–121.
- Marcovits JH: Hostility is associated with increased platelet activation in coronary heart disease. Psychosom Med 1998;60:586–591.
- Mangelli L, Fava GA, Grandi S, Grassi L, Ottolini F, Porcelli P, Rafanelli C, Rigatelli M, Sonino N: Assessing demoralization and depression in the setting of medical disease. J Clin Psychiatry 2005;66:391–394.
- Fava GA, Freyberger H, Bech P, Chistodoulou G, Sensky T, Theorell T, Wise TN: Diagnostic criteria for use in psychosomatic research. Psychother Psychosom 1995;63:1–8.
- Fava GA, Grandi S, Canestrari R: Prodromal symptoms in panic disorder with agoraphobia. Am J Psychiatry 1988;145:1564–1567.
- Fava GA, Grandi S, Rafanelli C, Canestrari R: Prodromal symptoms in panic disorder with agoraphobia. A replication study. J Affect Dis 1992;26:85–88.
- Fava GA, Grandi S, Canestrari R: Prodromal symptoms in primary major depressive disorders. J Affect Dis 1990;19:149–152.
- Fava GA, Savron G, Rafanelli C, Grandi S, Canestrari R: Prodromal symptoms in obsessive compulsive disorder. Psychopathology 1996;29:131–134.
-
Goldthorpe JH, Hope K: The Social Grading of Occupations. Oxford, Oxford University Press, 1974.
- Paykel ES: The Clinical Interview for Depression. J Affect Disord 1985;9:85–89.
- Spitzer RL, Wiliams JBW, Gibbon M, First MB: The Structured Clinical Interview for DSM-III-R (SCID). I. History, rationale and description. Arch Gen Psychiatry 1992;49:624–629.
- Grace SL, Abbey SE, Irvine J, Shnek ZM, Stewart DE: A prospective examination of anxiety persistence and its relationship to cardiac symptoms and recurrent cardiac events. Psychother Psychosom 2004;73:344–352.
- Littman AB: Review of psychosomatic aspects of cardiovascular disease. Psychother Psychosom 1993;60:148–167.
- Coelho R, Ramos E, Prata J, Barros H: Psychosocial indexes and cardiovascular risk factors in a community sample. Psychother Psychosom 2000;69:261–274.
-
Fava GA, Freyberger H (eds): Handbook of Psychosomatic Medicine. Madison, International Universities Press, 1998.
- Porcelli P, De Carne M, Fava GA: Assessing somatization in functional gastrointestinal disorders. Psychother Psychosom 2000;69:198–205.
- Grandi S, Fabbri S, Tossani E, Mangelli L, Branzi A, Magelli C: Psychological evaluation after cardiac transplantation. The integration of different criteria. Psychother Psychosom 2001;70:176–183.
- Rafanelli C, Roncuzzi R, Finos L, Tossani E, Tomba E, Mangelli L, Urbinati S, Pinelli G, Fava GA: Psychological assessment in cardiac rehabilitation. Psychother Psychosom 2003;72:343–349.
- Sonino N, Navarrini C, Ruini C, Ottolini F, Paoletta A, Fallo F, Boscaro M, Fava GA: Persistent psychological distress in patients treated for endocrine disease. Psychother Psychosom 2004;73:78–83.
- Bech P: Modern psychometrics in clinimetrics: Impact on clinical trials of antidepressants. Psychother Psychosom 2004;73:134–138.
- Faravelli C: Assessment of psychopathology. Psychother Psychosom 2004;73:139–141.
- Emmelkamp PMG: The additional value of clinimetrics needs to be established rather than assumed. Psychother Psychosom 2004;73:142–144.
- Fava GA, Ruini C, Rafanelli C: Psychometric theory is an obstacle to the progress of clinical research. Psychother Psychosom 2004;73:145–148.
Article / Publication Details
Published online: August 10, 2005
Issue release date: August 2005
Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 5
ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)
For additional information: https://www.karger.com/PPS
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Get Permission