Am J Psychiatry 1982; 139:1477-1480
Copyright © 1982 by American Psychiatric Association
Effect of denial on cardiac health and psychological assessment
JE Dimsdale and TP Hackett
To determine how denial of illness affects the relationship between
self-reported psychological state and cardiac status, the authors studied
204 men with heart disease. Differing degrees of denial masked the
relationship between multiple-vessel coronary disease and tension,
depression, or fatigue. At 1-year follow-up, denial confused the
relationship between fatigue and cardiac state. Denial may augment or
diminish risk; patients with high denial who did not complain of depression
or tension had a higher risk for coronary disease, and patients with low
denial who complained of fatigue had more morbidity at follow-up. Because
of its variable effects on illness and its role in confusing the
relationship between psychological state and disease, denial must be
evaluated carefully.
