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Published in: International Journal of Behavioral Medicine 6/2019

01-12-2019 | Mood Disorders | Brief Report

Alexithymia and Cardiac Outcome in Patients at First Acute Coronary Syndrome

Authors: Paolo Ossola, Maria Lidia Gerra, Marco Beltrani, Carlo Marchesi

Published in: International Journal of Behavioral Medicine | Issue 6/2019

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Abstract

Background

This cohort study was aimed to verify whether subjects at their first acute coronary syndrome (ACS) were more alexithymic than healthy controls (HC) and whether alexithymia can predispose patients with coronary artery disease to new major adverse cardiac events (MACE) during a 24-month follow-up period.

Methods

The sample included 100 HC with no history of depression or ACS and 304 never depressed patients with a first-ever ACS. A total of 266 patients completed the 2-year follow-up.

Results

Patients and HC reported similar Toronto Alexithymia Scale (TAS-20) scores. During the follow-up, 69 (22.69%) patients developed incident depression and 57 (18.75%) developed a new MACE. In a proportional hazard model, developing a first-ever depressive episode, but not alexithymia (hazard ratio = 1.008, 95% confidence interval = 0.984–1.033; p = 0.500), was associated with almost 3 times the risk of a recurrent cardiac event.

Conclusion

Incident depression, but not TAS-20 scores, represented risk factor for MACE.
Literature
1.
go back to reference Taylor GJ, Bagby RM. New trends in alexithymia research. Psychother Psychosom. 2004;73(2):68–77.CrossRef Taylor GJ, Bagby RM. New trends in alexithymia research. Psychother Psychosom. 2004;73(2):68–77.CrossRef
2.
go back to reference Bagby RM, Parker JD, Taylor GJ. The twenty-item Toronto alexithymia scale—I. item selection and cross-validation of the factor structure. J Psychosom Res. 1994;38(1):23–32.CrossRef Bagby RM, Parker JD, Taylor GJ. The twenty-item Toronto alexithymia scale—I. item selection and cross-validation of the factor structure. J Psychosom Res. 1994;38(1):23–32.CrossRef
3.
go back to reference Bagby RM, Taylor GJ, Parker JD. The twenty-item Toronto alexithymia scale—II. Convergent, discriminant, and concurrent validity. J Psychosom Res. 1994;38(1):33–40.CrossRef Bagby RM, Taylor GJ, Parker JD. The twenty-item Toronto alexithymia scale—II. Convergent, discriminant, and concurrent validity. J Psychosom Res. 1994;38(1):33–40.CrossRef
4.
go back to reference Kojima M. Alexithymia as a prognostic risk factor for health problems: a brief review of epidemiological studies. Biopsychosoc Med. 2012;6(1):21.CrossRef Kojima M. Alexithymia as a prognostic risk factor for health problems: a brief review of epidemiological studies. Biopsychosoc Med. 2012;6(1):21.CrossRef
5.
go back to reference Peters RM, Lumley MA. Relationship of alexithymia to cardiovascular disease risk factors among African Americans. Compr Psychiatry. 2007;48(1):34–41.CrossRef Peters RM, Lumley MA. Relationship of alexithymia to cardiovascular disease risk factors among African Americans. Compr Psychiatry. 2007;48(1):34–41.CrossRef
6.
go back to reference Marchesi C, Ossola P, Tonna M, De Panfilis C. The TAS-20 more likely measures negative affects rather than alexithymia itself in patients with major depression, panic disorder, eating disorders and substance use disorders. Compr Psychiatry. 2014;55:972–8.CrossRef Marchesi C, Ossola P, Tonna M, De Panfilis C. The TAS-20 more likely measures negative affects rather than alexithymia itself in patients with major depression, panic disorder, eating disorders and substance use disorders. Compr Psychiatry. 2014;55:972–8.CrossRef
7.
go back to reference Kojima M, Frasure-Smith N, Lespérance F. Alexithymia following myocardial infarction: psychometric properties and correlates of the Toronto alexithymia scale. J Psychosom Res. 2001;51:487–95.CrossRef Kojima M, Frasure-Smith N, Lespérance F. Alexithymia following myocardial infarction: psychometric properties and correlates of the Toronto alexithymia scale. J Psychosom Res. 2001;51:487–95.CrossRef
8.
go back to reference Marchesi C, Brusamonti E, Maggini C. Are alexithymia, depression, and anxiety distinct constructs in affective disorders? J Psychosom Res. 2000;49(1):43–9.CrossRef Marchesi C, Brusamonti E, Maggini C. Are alexithymia, depression, and anxiety distinct constructs in affective disorders? J Psychosom Res. 2000;49(1):43–9.CrossRef
9.
go back to reference Spitzer RL, Williams JB, Kroenke K, Linzer M, VerloindeGruy F, Hahn SR, et al. Utility of a new procedure for diagnosing mental disorders in primary care: the PRIME-MD 1000 study. Jama. 1994;272(22):1749–56.CrossRef Spitzer RL, Williams JB, Kroenke K, Linzer M, VerloindeGruy F, Hahn SR, et al. Utility of a new procedure for diagnosing mental disorders in primary care: the PRIME-MD 1000 study. Jama. 1994;272(22):1749–56.CrossRef
10.
go back to reference Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.CrossRef Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.CrossRef
11.
go back to reference Ossola P, Gerra ML, De Panfilis C, Tonna M, Marchesi C. Anxiety, depression, and cardiac outcomes after a first diagnosis of acute coronary syndrome. Health Psychol. 2018;37:1115–22.CrossRef Ossola P, Gerra ML, De Panfilis C, Tonna M, Marchesi C. Anxiety, depression, and cardiac outcomes after a first diagnosis of acute coronary syndrome. Health Psychol. 2018;37:1115–22.CrossRef
12.
go back to reference Eagle KA, Lim MJ, Dabbous OH, Pieper KS, Goldberg RJ, Van de Werf F, et al. A validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6-month post discharge death in an international registry. Jama. 2004;291(22):2727–33.CrossRef Eagle KA, Lim MJ, Dabbous OH, Pieper KS, Goldberg RJ, Van de Werf F, et al. A validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6-month post discharge death in an international registry. Jama. 2004;291(22):2727–33.CrossRef
13.
go back to reference Kauhanen J, Kaplan GA, Cohen RD, Salonen R, Salonen JT. Alexithymia may influence the diagnosis of coronary heart disease. Psychosom Med. 1994;56:237–44.CrossRef Kauhanen J, Kaplan GA, Cohen RD, Salonen R, Salonen JT. Alexithymia may influence the diagnosis of coronary heart disease. Psychosom Med. 1994;56:237–44.CrossRef
14.
go back to reference Valkamo M, Hintikka J, Niskanen L, Viinamäki H. Psychiatric morbidity and the presence and absence of angiographic coronary disease in patients with chest pain. Acta Psychiatr Scand. 2001;104:391–6.CrossRef Valkamo M, Hintikka J, Niskanen L, Viinamäki H. Psychiatric morbidity and the presence and absence of angiographic coronary disease in patients with chest pain. Acta Psychiatr Scand. 2001;104:391–6.CrossRef
15.
go back to reference Beresnevaité M, Taylor GJ, Bagby RM. Assessing alexithymia and type a behavior in coronary heart disease patients: a multimethod approach. PsychotherPsychosom. 2007;76:186–92. Beresnevaité M, Taylor GJ, Bagby RM. Assessing alexithymia and type a behavior in coronary heart disease patients: a multimethod approach. PsychotherPsychosom. 2007;76:186–92.
16.
go back to reference Tolmunen T, Lehto SM, Heliste M, Kurl S, Kauhanen J. Alexithymia is associated with increased cardiovascular mortality in middle-aged Finnish men. Psychosom Med. 2010;72:187–91.CrossRef Tolmunen T, Lehto SM, Heliste M, Kurl S, Kauhanen J. Alexithymia is associated with increased cardiovascular mortality in middle-aged Finnish men. Psychosom Med. 2010;72:187–91.CrossRef
17.
go back to reference Wiernik E, Lemogne C, Fezeu L, Arnault N, Hercberg S, Kesse-Guyot E, et al. Association between alexithymia and risk of incident cardiovascular diseases in the SupplémentationenVitamines et MinérauxAntioxydants (SU.VI.MAX) cohort. Psychosom Med. 2018;80(5):460–7.CrossRef Wiernik E, Lemogne C, Fezeu L, Arnault N, Hercberg S, Kesse-Guyot E, et al. Association between alexithymia and risk of incident cardiovascular diseases in the SupplémentationenVitamines et MinérauxAntioxydants (SU.VI.MAX) cohort. Psychosom Med. 2018;80(5):460–7.CrossRef
18.
go back to reference Marchesi C, Ossola P, Scagnelli F, Mellini L, Tonna M, Ardissino D, et al. The role of alexithymia in predicting incident depression in patients at first acute coronary syndrome. Compr Psychiatry. 2015;62:86–92.CrossRef Marchesi C, Ossola P, Scagnelli F, Mellini L, Tonna M, Ardissino D, et al. The role of alexithymia in predicting incident depression in patients at first acute coronary syndrome. Compr Psychiatry. 2015;62:86–92.CrossRef
Metadata
Title
Alexithymia and Cardiac Outcome in Patients at First Acute Coronary Syndrome
Authors
Paolo Ossola
Maria Lidia Gerra
Marco Beltrani
Carlo Marchesi
Publication date
01-12-2019
Publisher
Springer US
Published in
International Journal of Behavioral Medicine / Issue 6/2019
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-019-09823-1

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