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Psychologic Distress in Postmyocardial Infarction Patients Who Have Returned to Work

Chantal Brisson, PhD, Richard Leblanc, PhD, Renée Bourbonnais, PhD, Elizabeth Maunsell, PhD, Gilles R. Dagenais, MD, Michel Vézina, MD, Benoît Msse, PhD and Edeltraut Kröger, MSc

From the Unité de recherche en santé des populations, Québec, Canada (C.B., R.L., E.M.); Université Laval, Québec, Canada (C.B., R.B., E.M., M.V., E.K.); Institut de cardiologie de Québec, Québec, Canada (G.R.D.); and Fred Hutchinson Cancer Research Center, Seattle, Washington (B.M.).

Address correspondence and reprint requests to Chantal Brisson, PhD, Unité de recherche en santé des populations, Centre hospitalier affilié universitaire de Québec, Hôpital Saint-Sacrement, 1050 Chemin Sainte-Foy, Québec, Québec, Canada G1S 4L8. E-mail: cbrisson{at}uresp.ulaval.ca

Objective: To assess the prevalence of psychologic distress in women and men returning to work after a myocardial infarction (MI) and to compare this prevalence with the prevalence observed among men and women of the general working population.

Methods: The study population was composed of 990 post-MI patients (106 women and 884 men) recruited in 30 hospitals who had returned to work after their first MI. Psychologic distress was measured with the French version of the Psychiatric Symptom Index (PSI). Adjusted mean PSI score and prevalence of psychologic distress were compared with those observed in 8829 other workers (3823 women and 5006 men), representative of the general working population.

Results: Mean PSI score was higher in post-MI women (30.3) than in post-MI men (20.3). This score was also higher in the post-MI population than in the general working population, both for women (30.3 compared with 17.0) and men (20.3 compared with 14.1). Psychologic distress was more prevalent in post-MI women than in post-MI men (prevalence ratio [PR], 1.62; confidence interval [CI], 1.27–2.07). This score was also higher in post-MI women and post-MI men than in the general working population (PR, 2.18; CI, 1.75–2.71 and 1.76; CI, 1.48–2.08, respectively).

Conclusions: Among the presumably fittest post-MI patients, namely those who had returned to work, psychologic distress was significantly more prevalent than in the general working population, particularly among women. Further research is needed to shed light on prognosis in post-MI workers experiencing psychologic distress and on adequate intervention before and after their return to work.

Key Words: psychologic distress • post-MI patients • return to work

Abbreviations: PR = prevalence ratio; CI = confidence interval; MI = myocardial infarction; PSI = Psychiatric Symptom Index.