Denial and medical outcome in unstable angina.

Abstract:

:Denial may be adaptive during hospitalization for acute coronary disease. We studied the impact of denial in 48 patients referred to a tertiary care center for treatment of unstable angina. Using the Hackett-Cassem Denial Scale, we divided the group into 25 high deniers and 23 low deniers. The two groups were comparable in baseline demographic and social data, coronary risk factors, cardiac history, medical treatment, vital signs, and cardiac catheterization results (number of diseased vessels and ejection fraction). Compared to low deniers, high deniers had half as many episodes of angina during hospitalization (1.3 vs. 2.5; p less than 0.03, t = 2.2, df = 46) and were more likely to reach medical stabilization, i.e., pain free for 36 hr (92% vs. 65%, p less than 0.03, Fisher exact probability test). Intravenous nitroglycerin drips were also required less often in high deniers (32% vs. 78%, p = 0.002, Fisher exact). Two myocardial infarctions and one death occurred, all in low deniers. We conclude that denial independently predicts better medical outcome during acute hospitalization for unstable angina.

journal_name

Psychosom Med

journal_title

Psychosomatic medicine

authors

Levenson JL,Mishra A,Hamer RM,Hastillo A

doi

10.1097/00006842-198901000-00003

subject

Has Abstract

pub_date

1989-01-01 00:00:00

pages

27-35

issue

1

eissn

0033-3174

issn

1534-7796

journal_volume

51

pub_type

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