Personality and Defence Mechanisms in Takotsubo Cardiomyopathy

Abstract

Introduction

Takotsubo cardiomyopathy (TC) is an acute cardiologic syndrome, characterized by specific symptoms and ECG, echocardiographic and enzymatic abnormalities, similar to an acute myocardial infarction, with no hemodynamically significant stenosis at coronary-ventriculography.

Objective

To assess personality in TC patients in order to find common psychopathological elements.

Methods

A series of consecutive patients suffering from TC hospitalized at the Cardiology Unit of “Ingrassia” Hospital in Palermo in 2013–2014, were included in the study. We used Structured Clinical Interview for Axis I and II, according to DSM-IV TR criteria. Further, the Defense Mechanisms Inventory (DMI), used in order to explore defensive strategies: turning against self (TAS), projection (PRO), principalization (PRN), turning against object (TAO), and reversal (REV).

Results

Eight women (mean age + SD: 57 ± 5 years) have been included in the study. A common element of them was a stressful event immediately preceding the onset of TC, in particular bereavement (4), armed robbery (1), infarction of a family member (1), estrangement of a family member (1), and separation from a partner (1). Although the patients did not fulfill any diagnostic criteria for Axis I or Axis II disorders of DSM-IV-TR, they showed scores at the SCID-II close to the limit values for avoidant and dependent personality .DMI showed, unequivocally, the common use of TAS-type defence style.

Conclusions

Although the sample size was too small for complex statistical analyses, nevertheless our initial findings would indicate the presence of a common, defensive style in TC patients, and how this syndrome may be related to stressful life events.

Disclosure of interest

The authors have not supplied their declaration of competing interest.