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The Psychology of an Angiogram

A new study of heart patients in a New Zealand hospital suggests people in pain go to the doctor expecting the worst.
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A research team headed by Daniel Devcich and Keith Petrie of the University of Auckland’s department of psychological medicine interviewed 57 cardiology patients at Auckland City Hospital in the summer of 2006. Each was asked about their physical symptoms and their emotional state immediately before and after they received the results of an angiogram — a test that told them whether they suffered from blocked arteries and were therefore likely to need surgery.

The results, reported in the Journal of Psychosomatic Research, confirm the psychological power of a professional diagnosis. Those diagnosed with healthy arteries reported a decrease in symptoms and a lessening of anxiety. Those diagnosed with diseased arteries reported their perception of their symptoms, and their emotional state, remained unchanged.

“Immediately following receiving normal test results, patients engage in a cognitive reappraisal of their symptoms in response to this new information,” the researchers conclude. “Symptoms previously seen as signs of an illness threat are subsequently minimized or re-evaluated as nonthreatening.”

The fact patients who received bad news did not feel any worse, physically or emotionally, suggests they “may have already prepared themselves for receiving an unfavorable diagnostic outcome.”

These are short-term results, and the study suggests more research should be done to look at whether they hold up in the weeks after a diagnosis. But they suggest that, if you are avoiding a medical test for fear you can’t psychologically handle a bad result, you might want to think again. It’s quite possible that the state of not knowing is just as traumatic as dealing with a frightening diagnosis.