Personality and Defence Mechanisms in Takotsubo Cardiomyopathy

ntroduction Takotsubo cardiomyopathy (TC) is an acute cardi- ologic 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 hos- pitalized 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±5years) have been included in the study. A common element of them was a stressful event immediately preceding the onset of TC, in particular bereave- ment (4), armed robbery (1), infarction of a family member (1), estrangement of a family member (1), and separation from a part- ner (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 per- sonality .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 decla- ration of competing interest.