Alexithymia is a determinant of early death in the long-term course of post-myocardial infarction

  • Mauro Giovanni Carta
    Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Federica Sancassiani
    Department of Medical Sciences and Public Health, University of Cagliari, Italy. https://orcid.org/0000-0002-7963-5281
  • Davide Bina
    Department of Medical Sciences and Public Health, University of Cagliari, Italy. https://orcid.org/0000-0002-3526-6322
  • Marco Licciardi
    Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Giulia Cossu
    Department of Medical Sciences and Public Health, University of Cagliari, Italy. https://orcid.org/0000-0002-1245-016X
  • Antonio Egidio Nardi
    Laboratory of Panic and Respiration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil.
  • Luigi Meloni
    Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Roberta Montisci
    Department of Medical Sciences and Public Health, University of Cagliari, Italy. https://orcid.org/0000-0002-7218-6751

ABSTRACT

Among people with ST-segment elevation myocardial infarction (STEMI), high alexithymia was associated with delay to hospital arrival. High alexithymia could be a determinant of early death in the long term after STEMI. People with STEMI who participated in a survey in 2011, was tested about the state of life in 2021. The sample was divided into two cohorts (cut-off: TAS-20≥61 in 2011). The relationship between possible death occurred and having high alexithymia was calculated by comparing the mortality after 10 years in the two cohorts through the Cox’ proportional hazard model. Status in life was verified on 39.3% of the sample. No differences were found regarding age, sex, high alexithymia between individuals on whom it was possible to verify the state in life and in whose it was not. In 2021, among people having high alexithymia in 2011, a higher risk of early death was found (RR=5.75, CI 95% 1.116-29.637).

REFERENCES

Bressi C, Taylor GJ, Parker JDA, et al. Cross validation of the factor structure of the 20-item Toronto Alexithymia Scale: an Italian multicenter study. J Psychosom Res 1996;41:551–9. DOI: https://doi.org/10.1016/S0022-3999(96)00228-0

Carta MG, Sancassiani F, Pippia V, Bhat KM, et al Alexithymia is associated with delayed treatment seeking in acute myocardial infarction. Psychother Psychosom 2013;82:190-2. DOI: https://doi.org/10.1159/000341181

Preti A, Sancassiani F, Cadoni F, Carta MG. Alexithymia affects pre-hospital delay of patients with acute myocardial infarction: meta-analysis of existing studies. Clin Pract Epidemiol Ment Health 2013;9:69-73. DOI: https://doi.org/10.2174/1745017901309010069

Sancassiani F, Montisci R, Preti A, et al. Surviving to acute myocardial infarction: The role of psychological factors and alexithymia in delayed time to searching care: A systematic review. J Clin Med 2021;10:3813. DOI: https://doi.org/10.3390/jcm10173813

Meloni L, Montisci R, Pippia V, et al. Alexithymia affects the time from symptom onset to calling the emergency system in STEMI patients referred for primary PCI. Int J Cardiol 201615;219:428-32. DOI: https://doi.org/10.1016/j.ijcard.2016.06.038

Giugliano RP, Braunwald E, TIMI Study Group: Selecting the best reperfusion strategy in ST-elevation myocardial infarction: it’s all a matter of time. Circulation 2003;108:2828–30. DOI: https://doi.org/10.1161/01.CIR.0000106684.71725.98

Taylor GJ, Bagby RM. Examining proposed changes to the conceptualization of the alexithymia construct: The way forward tilts to the past. Psychother Psychosom 2021;90:145-55. DOI: https://doi.org/10.1159/000511988

Rady A, Alamrawy RG, Ramadan I, El Raouf MA. Prevalence of alexithymia in patients with medically unexplained physical symptoms: A cross-sectional study in Egypt. Clin Pract Epidemiol Ment Health 2021;17:136-45. DOI: https://doi.org/10.2174/1745017902117010136

Abbass A, Town J, Holmes H, et al. Short-term psychodynamic psychotherapy for functional somatic disorders: A meta-analysis of randomized controlled trials. Psychother Psychosom 2020;89:363-70. DOI: https://doi.org/10.1159/000507738

Terock J, Janowitz D, Grabe HJ, et al. Alexithymia and psychotherapeutic treatment motivation: Main and interactional effects on treatment outcome. Psychother Psychosom 2017;86:185-6. DOI: https://doi.org/10.1159/000457961

Law MR, Watt HC, Wald NJ. The underlying risk of death after myocardial infarction in the absence of treatment. Arch Intern Med 2002;162:2405-10. DOI: https://doi.org/10.1001/archinte.162.21.2405

Olivari Z, Steffenino G, Savonitto S, et al. The management of acute myocardial infarction in the cardiological intensive care units in Italy: the “Blitz 4 Qualità” campaign for performance measurement and quality improvement. Eur Heart J Acute Cardiovasc Care 2012;1:143-52. DOI: https://doi.org/10.1177/2048872612450520

Rizzello V, Lucci D, Maggioni AP, et al. Clinical epidemiology, management and outcome of acute coronary syndromes in the Italian network on acute coronary syndromes (IN-ACS Outcome study). Acute Card Care 2012;14:71-80. DOI: https://doi.org/10.3109/17482941.2012.655296

Beresnevaite M: Exploring the benefits of group psychotherapy in reducing alexithymia in coronary heart disease patients: a preliminary study. Psychother Psychosom 2000;69:117-22. DOI: https://doi.org/10.1159/000012378

Ogrodniczuk JS, Joyce AS, Piper WE. Change in alexithymia in two dynamically informed individual psychotherapies. Psychother Psychosom 2013;82:61-3. DOI: https://doi.org/10.1159/000341180