Long-term mental health of men after a first acute myocardial infarction

Arch Phys Med Rehabil. 2002 Mar;83(3):352-9. doi: 10.1053/apmr.2002.30616.


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.

Design: Longitudinal study.

Setting: Eight medical centers in central Israel.

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

Intervention: 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.

Main outcome measures: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Educational Status
  • Humans
  • Israel
  • Longitudinal Studies
  • Male
  • Mental Health*
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / psychology*
  • Myocardial Infarction / rehabilitation
  • Social Support
  • Stress, Psychological / etiology*
  • Surveys and Questionnaires
  • Time Factors