Post-MI Anxiety More Common among Women: Be Sure to Start Patients on Anxiolytics Quickly after Anxiety Is Diagnosed Post Myocardial Infarction

By Zoler, Mitchel L. | Clinical Psychiatry News, February 2007 | Go to article overview

Post-MI Anxiety More Common among Women: Be Sure to Start Patients on Anxiolytics Quickly after Anxiety Is Diagnosed Post Myocardial Infarction


Zoler, Mitchel L., Clinical Psychiatry News


CHICAGO -- The high anxiety that many women have after an acute myocardial infarction may explain their high complication rate, compared with men, and it may offer a new way to improve patient outcomes.

"Early recognition and effective treatment of anxiety immediately after a myocardial infarction may decrease morbidity and mortality," Debra K. Moser, D.N.Sc., said while presenting a poster at the annual scientific sessions of the American Heart Association. 'Anxiety is a target for intervention. "One of the things most lacking in clinical cardiology today is the assessment of anxiety and depression" in AMI patients, she said.

The Brief Symptom Inventory (BSI) is the way that Dr. Moser and her associates have measured anxiety in patients after an acute myocardial infarction (AMI), and treatment can include an anxiolytic drug as well as psychosocial interventions such as cognitive-behavioral therapy, said Dr. Moser, professor of nursing at the University of Kentucky, Lexington.

She and her associates examined the role of anxiety after AMI in 635 men and 244 women who were enrolled at several centers in the United States and four other countries. The anxiety level of all patients was measured within 72 hours of their hospital admission for their AMI using the BSI.

The BSI is a reliable and validated measure that uses six questions to measure anxiety, said Dr. Moser. Each question is rated on a scale of 0-4 (0 is the lowest level), and the scores from all six questions are summed and then averaged. A score of 0.33 or less indicates no anxiety. A score of 0.4 or more indicates clinically significant anxiety, especially if the score persists at this level over time. A score of 1.7 is what is typically seen in psychiatric patients who are hospitalized for anxiety disorders. Results from prior studies by Dr. Moser and her associates showed that about 44% of AMI patients have mild or moderate anxiety, and about 25% have a BSI score of 1.7 or higher (the remaining patients do not have anxiety).

The average post-MI BSI score among the women in this study was 0. …

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