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Psychosomatic Medicine 36:327-343 (1974)
© 1974 American Psychosomatic Society

A Psychological Questionnaire Predictive of Myocardial Infarction: Results from the Kaiser-Permanente Epidemiologic Study of Myocardial Infarction

GARY D. FRIEDMAN MD, MS1, HANS K. URY PHD1, ARTHUR L. KLATSKY MD1, and A. B. SIEGELAUB MS1

1 Departments of Medical Methods Research and Internal Medicine (Oakland), Kaiser-Permanente Medical Care Program, Oakland, California

A 155-item psychological questionnaire was given to 330 multiphasic examinees who subsequently developed a well-documented first myocardial infarction (MI). Two age-sex-race-matched control groups remaining free of MI were selected from multiphasic examinees; one group was additionally matched to the cases for standard coronary risk factors. Responses to several questionnaire items were associated with subsequent MI to a statistically significant degree, and a further test indicated that the questionnaire as a whole contained more associated items than would be expected by chance. Outside experts selected items to represent certain psychological traits that have been hypothesized as predicting MI. Items representing "emotional drain" and "somatization" proved to be associated with subsequent MI, but these relationships were no longer apparent when persons with coronary symptoms and diagnoses at the time of testing were removed from the study group. Sets of items representing certain other traits were not significantly predictive, except for those representing "anxietyneuroticism," in the symptom-free subgroup. In studying factors predicting MI, care should be taken that psychological traits are not confused with symptoms of coronary heart disease.

Submitted on November 28, 1973
Revised on February 19, 1974




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P. G. O'Malley, D. L. Jones, I. M. Feuerstein, and A. J. Taylor
Lack of Correlation between Psychological Factors and Subclinical Coronary Artery Disease
N. Engl. J. Med., November 2, 2000; 343(18): 1298 - 1304.
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