Article
Long-term mental health of women after a first acute myocardial infarction1,

https://doi.org/10.1016/S0003-9993(03)00316-2Get rights and content

Abstract

Drory Y, Kravetz S, Hirschberger G, for the Israel Study Group on First Acute Myocardial Infarction. Long-term mental health of women after a first acute myocardial infarction. Arch Phys Med Rehabil 2003;84:1492–8.

Objectives

To compare the long-term psychologic well-being and psychologic distress, after a first acute myocardial infarction (AMI), of women with those of men and those of a normative community sample of women and to examine the relation of sociodemographic, medical, and psychologic variables to the long-term psychologic well-being and psychologic distress of women.

Design

Longitudinal study.

Setting

Eight medical centers in central Israel.

Participants

Sixty-two women (age range, 30–65y) with documented first AMI.

Interventions

Sociodemographic, medical, and psychologic data were collected before hospital discharge (T1). Psychologic well-being and psychologic distress were assessed 5 years after AMI (T2) with the Mental Health Inventory.

Main outcome measures

Hierarchical regression was used to examine the relations among the outcome variables, psychologic well-being, and psychologic distress at T2 and the predictors, sociodemographic, medical, and psychologic variables at T1.

Results

Women had less long-term psychologic well-being and more psychologic distress after AMI than did men or the normative sample of women. Depression and concomitant medical problems were related to women’s psychologic well-being; depression alone was related to their long-term psychologic distress.

Conclusions

Women with an AMI are more likely than men to have reduced psychologic well-being and increased psychologic distress. In addition, diminished mental health was related to medical and psychologic pathogenic factors.

Section snippets

participants

Sixty-two Israeli women with a documented first AMI who were admitted into any of 8 medical centers in central Israel participated. The medical, sociodemographic, and psychologic characteristics of these women are described in table 2. The characteristics were compared with those of a sample of men 5 years after a first AMI that were reported by Drory et al.13 Women differed from men to a statistically significant degree in age, ethnic background, lack of a permanent partner, concomitant

Results

Table 3 presents the means and standard deviations (SDs) of the psychologic well-being and the psychologic distress levels for the 62 women 5 years after an AMI. These means and SDs were compared with the means and SDs of 209 men 5 years after AMI who were taken from the study of Drory et al13 and with the means and SDs of a normative community sample of 151 women between the ages of 35 and 65 years. Data for the normative sample were taken from a study of the psychometric properties of the MHI

Discussion

The present study’s findings suggest that women with an AMI are more likely than men to experience a reduction in their mental health status. Five years after AMI, women reported less psychologic well-being and more psychologic distress than that experienced by men and by a normative community sample of women. In a previous study with a sample of men 5 years after AMI,13 no statistically significant difference was found between the psychologic well-being of those men and the psychologic

Conclusion

Despite the above limitations, the study indicates that women after a first AMI have a decreased mental health status when compared with men. However, research that considers the above limitations is necessary to determine the extent to which the gender differences in personal and social resources, and in the long-term psychosocial adjustment to an AMI uncovered in this study, reflect differences in the physical, psychologic, and social condition of women and men. Surveys of the use of

Acknowledgements

We thank Dov Har-Even and Yoav Bilinski for their assistance in statistical analysis and database management. The following investigators and institutions participated in the Israel Study Group on First Acute Myocardial Infarction. Principal investigator: Yaacov Drory, MD, Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv; Yeheskiel Kishon, MD, Michael Kriwisky, MD, and Yoseph Rosenman, MD, Wolfson Medical

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    Supported in part by the Chief Scientist, Israel Ministry of Health; the National Insurance Institute; the Administrator General, Israel Ministry of Justice; the Committee for Research and Prevention in Occupational Safety and Health, Israel Ministry of Labor and Welfare; the Tel-Aviv University Research Fund; and the Edith and Israel Pollak Foundation, Tel-Aviv, Israel.

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    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

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