Neuropsychological Deficits, Depression and Type a Behavior Pattern in Patients with Myocardial Infarction

Abstract

In cardiovascular disease, which is one of the leading causes of death in developing countries, the majority of deaths are due to myocardial infarction (MI). Myocardial infarction occurs when the blood supply to parts of the heart is interrupted causing some heart cells to die. Myocardial infarction may lead to cognitive deficits. The main causes or risk factors of myocardial infarction are hypertension, diabetes mellitus and tobacco use. Psychosocial factors such as Type A behavior pattern or coronary prone behavior and depression have been reported to be associated with myocardial infarction. The aim of the present study was to examine the presence of depression and neuropsychological deficits in patients with myocardial infarction. In addition, Type A behavior pattern or coronary prone behavior of patients with MI was also examined. The sample consisted of 40 MI patients and the tests were administered within one week after hospitalization. A healthy normal comparison group of 40 subjects, who were matched with respect to age, education, gender, place and state of residence with the MI patient group, was also selected for the study. The tools used were Beck depression inventory, Edinburgh Handedness inventory, Type A/B behaviour pattern scale, General Health Questionnaire, and tests from NIMHANS Neuropsychological test battery. The results showed that neuropsychological performances of the MI patient group were significantly poor in the domains of mental speed and information processing; sustained attention; executive functions: category fluency, phonemic fluency, verbal working memory and response inhibition; verbal learning and memory; visual learning and memory; and visuo-spatial ability compared to the healthy normal matched group. Moreover, 52.5% of the MI patients were depressed. Type A behavior was significantly linked to myocardial infarction. The cognitive deficits and depression which are seen in the present study might have resulted from the disruption of neural networks that connect cortical and subcortical regions of the brain. Index Terms—Myocardial infarction, type a behavior, depression.