Denial predicts favorable outcome in unstable angina pectoris

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...

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Bibliographic Details
Published in:Psychosomatic medicine 1984, Vol.46 (1), p.25-32
Main Authors: LEVENSON, J. L, KAY, R, MONTEFERRANTE, J, HERMAN, M. V
Format: Article
Language:English
Subjects:
Angina Pectoris - psychology
Angina, Unstable - drug therapy
Angina, Unstable - psychology
Biological and medical sciences
Coronary Care Units
Denial (Psychology)
Drug Therapy, Combination
Female
General aspects
Humans
Male
Medical sciences
Middle Aged
Prognosis
Psychological Tests
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
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Summary: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.
ISSN:0033-3174
1534-7796
DOI:10.1097/00006842-198401000-00005