Many post-heart attack workers have psych symptoms

Men and women who are fit enough to return to work within a year after a heart attack may experience ongoing psychologic distress, new study findings suggest. In comparison to other workers, these heart attack survivors have more symptoms of depression and anxiety.

"The results of the study show that the psychologic health of post-(heart attack) workers remains significantly below levels observed in other workers," study author Dr. Chantal Brisson of the Universite Laval in Quebec, Canada, and her colleagues write in the current issue of Psychosomatic Medicine.

"Psychologic distress increases the risk of recurrence and mortality," the researchers note.

Research suggests that about 50 percent of men and women experience high levels of psychologic distress after heart attack, but such distress is known to decrease in the following months. Whether this is true among the fittest heart attack patients - those who return to work soon afterwards - is unknown.

To investigate, Brisson and her team studied 990 men and women, no more than 60 years of age, who returned to work about four months after experiencing a heart attack. All of the study participants were interviewed within four weeks after returning to work. For comparison, the study also included 8,829 workers who had not experienced heart attack.

The researchers found that the heart attack patients scored higher on a measure of the presence and intensity of depressive symptoms, anxiety, mental disturbances and anger, than did those from the general working population.

Within the study group, however, women had higher psychiatric scores than did men, the authors report.

For example, women scored an average 32.9 in depressive symptoms, whereas men scored an average 19.9. Depression scores among the comparison group were 15.9 for women and 12.1 for men. Similarly, women who returned to work after having had a heart attack scored 45.6 in a measure of their anxiety, while men scored 32.6. Their female and male counterparts who had not experienced heart attack scored 26.6 and 23.1, respectively.

Overall, the researchers found that slightly more than half of women and nearly a third of men in the study group experienced psychologic distress upon returning to work after experiencing a heart attack. Among those in the comparison group, less than a quarter of women and about a fifth of men had similar symptoms.

In light of the findings, "further research is needed to shed light on prognosis in post-(heart attack) workers experiencing psychologic distress and on adequate intervention before and after their return to work," the authors conclude.

SOURCE: Psychosomatic Medicine, January/February 2005.