Selection of psychotherapeutic treatment for adjustment disorder with depressive mood due to acute myocardial infarction

Background. There is a lack of specific emotional treatment in patients with adjustment disorder (AD) with depressed mood (DSM-IV-TR: 309.0) as a consequence of acute myocardial infarction (AMI) (ICD 10: 410.0-9), which renders treatment even more difficult. The present study proposed a new therapeutic technique (mirror therapy) to compare this with other therapies. Our objective was to select among three different treatment types the most effective treatment against AD in patients with AMI. Methods. We used a quasi-experimental design for four groups with three evaluations each, which we carried out at three Mexican Social Security Institute (IMSS) hospitals in the metropolitan zone of Mexico City. We conducted a random test of 144 patients of both genders between 30 and 60 years of age diagnosed with AMI and AD and selected by means of the Minnesota multiphasic personality inventory (MMPI-2) neurotic depressive scale. Treatment evaluation was carried out with depressive description test (DDT) and MMPI-2 test, and depression (DEP) and health concerns (HEA) content scales. Results. We observed in post-test evaluation a significant difference between patients in the psychotherapy mirror group and the remaining groups (p<0.05). During the 6-month follow-up evaluation, we observed in HEA content scale a significant difference between control. group and remaining groups (p<0.05). Conclusions. Mirror psychotherapy treatment is more effective in AD symptom decrease. Patients with AMI and AD not receiving emotional support treatment in conjunction with medical treatment continue to experience emotional disorders and show greater apprehension with regard to medical treatments. (C) 2003 IMSS. Published by Elsevier Science Inc.