title: Alexithymia affects pre-hospital delay of patients with acute myocardial infarction: meta-analysis of existing studies.
abstract: BACKGROUND
  The time between the onset of symptoms and reperfusion is a critical determinant of the clinical course of patients with acute myocardial infarction (AMI). Any delay in seeking help will affect patient's outcome. Alexithymia can influence the information processing but also the skills to detect the signal of an ongoing AMI.
  
  
  METHODS
  Systematic review and meta-analysis of studies investigating the role of alexithymia in pre-hospital delay after AMI. Pubmed/Medline and PsychINFO/Ovid search from 1990 until 2012.
  
  
  RESULTS
  Out of 29 studies investigating the role of psychological factors in pre-hospital delay after AMI, 3 studies specifically assessed alexithymia, involving 258 patients. All studies used the Toronto Alexithymia Scale to group patients into clusters by time to presentation after AMI. Meta-analysis of data showed that the patients with higher emotional awareness (i.e., low alexithymia) had shorter time to presentation after AMI.
  
  
  CONCLUSIONS
  Preliminary evidence indicates that alexithymia may have a role in seeking help delay after AMI. Further studies are necessary to better appreciate how alexithymia influence help-seeking in patients with an evolving AMI and in what extent their ineffective behavior can be changed.
authors.affiliation: Department of Public Health, Clincial and Molecular Medicine, University of Cagliari and Center for Consultation-Liaison Psychiatry and Psychosomatics, University Hospital of Cagliari, Cagliari, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Preti
authors.forename: Federica
authors.initials: F
authors.lastname: Sancassiani
authors.forename: Federica
authors.initials: F
authors.lastname: Cadoni
authors.forename: Mauro Giovanni
authors.initials: MG
authors.lastname: Carta
keywords: Pre-hospital delay; acute myocardial infarction; alexithymia; care seeking behavior.; psychological factors