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Adverse childhood experiences and the structure of personality in patients with takotsubo syndrome versus myocardial infarction
Lutz Goetzmann1, Elisabeth Olliges2, Barbara Ruettner3, Karin Meissner4, Karl-Heinz Ladwig5, Christian Möller6, Daniela Deftu-Kloes1, Stefan Pohl1, Gert Richardt7, Christoph Burgdorf8, Alexander Steger9, Joram Ronel10
1 Department of Psychosomatic Medicine and Psychotherapy, Segeberger Kliniken, Bad Segeberg, Germany
2 Department of Medical Psychology, Faculty of Medicine, LMU Munich, Germany
3 Department of Psychology, Medical School Hamburg, Germany
4 Division of Health Promotion, University of Applied Sciences, Coburg, Germany
5 Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Germany
6 Department of Cardiology, Angiology and Intensive Care Medicine, Medical Clinic II, University Heart Center Lübeck, Germany
7 Department of Cardiology, Segeberger Kliniken, Bad Segeberg, Germany
8 Department of Cardiology, Heart and Vascular Centre, Bad Bevensen, Germany
9 Medical Clinic and Policlinic I, Technical University of Munich, Germany
10 Department of Psychosomatic Medicine, Klinik Barmelweid, Barmelweid, Switzerland
Correspondence Address:
Dr. Lutz Goetzmann
Department of Psychosomatic Medicine and Psychotherapy, Segeberger Kliniken, Am Kurpark 1, 23795 Bad Segeberg
Germany
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/hm.hm_76_19
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Context and Aims: Psychosocial risk factors are known to result in either takotsubo syndrome (TTS) or myocardial infarction (MI). In this article, the results of a cross-sectional study are presented within the framework of “progressive somatization” by comparing the psychosocial traits of TTS and MI patients. Design/Subjects and Methods: 136 patients were administered a battery of questionnaires comprising the Childhood Trauma Questionnaire (CTQ), the Toronto Alexithymia Scale (TAS-20), the Experiences in Close Relationships-Revised Questionnaire, and the Operationalised Psychodynamic Diagnosis Structural Questionnaire (OPD-SQ). Life events prior to the onset of cardiac disease were recorded. Statistical Analysis: Descriptive statistics data were expressed in absolute numbers, percent, and mean and standard deviation. To identify differences between groups, T-tests for independent samples, Chi-square-tests and Mann-Whitney-Tests were used. Pearson correlations were computed to assess the relationship between the patient samples as well as between the patient samples and norms. Results: Few differences were found between TTS and MI patients, with both groups reporting moderate-to-severe “emotional neglect” in their childhood (CTQ). Compared to the norm group, TTS and MI patients showed higher values of “alexithymia” (TAS-20), and MI patients reported higher “attachment avoidance”. There are more “structural limitations of the personality” in TTS and MI patients than in a psychosomatic sample (OPD-SQ). Conclusions: TTS as well as MI patients suffer from “adverse childhood experiences” and “structural limitations of personality.” The results sustain the psychosomatic theory of progressive somatization that leads to severe bodily diseases. Patients might benefit from a specific psychotherapeutical support.
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