Long-term mental health of men after a first acute myocardial infarction.
OBJECTIVE
To evaluate the differential and independent impact of sociodemographic, medical, and psychologic variables assessed at hospital discharge on patients' short- and long-term mental health.


METHODS
Longitudinal study.


METHODS
Eight medical centers in central Israel.


METHODS
Male Israeli patients (N = 209; age range: 30-65 y) with documented first acute myocardial infarction (AMI).


METHODS
Subjects were interviewed 3 times, once (T1) before hospital discharge, a second time (T2) at 3 to 6 months after discharge, and a third time (T3) at 5 years post-AMI. Sociodemographic, medical, and psychologic data were elicited at the first interview and completed with medical information in the files. Psychologic well-being and psychologic distress were evaluated by the Mental Health Inventory at the second and third interviews. These 2 outcome variables were compared with normative community data on these aspects of mental health.


METHODS
Hierarchical regression was used to examine the relation between the independent variables, sociodemographic, medical, and psychologic variables, and the dependent variables, psychologic well-being and psychologic distress, at T2 and T3.


RESULTS
Depression, perceived health, sense of coherence, social support, and educational level at discharge predicted aspects of mental health 3 to 6 months and 5 years post-AMI. However, only psychologic distress differentiated between the research participants and the normative community sample of men.


CONCLUSIONS
A first episode of AMI appears to increase psychologic distress more than it decreases psychologic well-being both 3 to 6 months and 5 years post-AMI. Educational level and sense of coherence may serve as protective factors, whereas depression may foster vulnerability to distress and impaired psychologic well-being.
Drory
Yaacov
Y
Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel.
Kravetz
Shlomo
S
Hirschberger
Gilad
G
D000328:Adult; D000368:Aged; D004522:Educational Status; D006801:Humans; D007557:Israel; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D013997:Time Factors