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Fang, X. ; Albarqouni, L. ; von Eisenhart Rothe, A. ; Hoschar, S. ; Ronel, J.* ; Ladwig, K.-H.

Is denial a maladaptive coping mechanism which prolongs pre-hospital delay in patients with ST-segment elevation myocardial infarction?

J. Psychosomat. Res. 91, 68-74 (2016)
Postprint DOI
Open Access Green
Objective During an acute myocardial infarction, patients often use denial as a coping mechanism which may provide positive mood regulating effects but may also prolong prehospital delay time (PHD). However, empirical evidences are still sparse. Methods This cross-sectional study included 533 ST-elevated myocardial infarction (STEMI) patients from the Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) study. Data on sociodemographic, clinical and psycho-behavioral characteristics were collected at bedside. The outcome was assessed using the Cardiac Denial of Impact Scale (CDIS) with the median split as cutoff point. A total of 206 (41.8%) STEMI patients were thus classified as deniers. Results Deniers were less likely to suffer from major depression (p = 0.04), anxiety (p = 0.01) and suboptimal well-being (p = 0.01) compared to non-deniers during the last six months prior to STEMI. During STEMI, they were less likely to perceive severe pain strength (p = 0.04) and racing heart (p = 0.02). Male deniers were also less likely to perceive shortness of breath (p = 0.03) and vomiting (p = 0.01). Denial was not associated with overall delay time. However, in the time window of 3 to 24 h, denial accounted for roughly 40 min extra delay (356 vs. 316.5 min p = 0.02 n = 196). Conclusions Denial not only contributes to less suffering from acute heart related symptoms and negative affectivity but also leads to a clinically significant delay in the prevalent group.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Behavior Response ; Decision Time ; Denial ; Prehospital Delay; Acute Coronary Syndromes; Negative Affectivity; Social Inhibition; D Personality; Symptoms; Illness; Perceptions; Predictors; Adherence; Disease
ISSN (print) / ISBN 0022-3999
e-ISSN 1879-1360
Zeitschrift Journal of Psychosomatic Research
Quellenangaben Band: 91, Heft: , Seiten: 68-74 Artikelnummer: , Supplement: ,
Verlag Elsevier
Verlagsort Oxford
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Epidemiology II (EPI2)