CONGRESS ABSTRACT

Background: Sleep has been associated to cardiac events and major cardiovascular events Studies on the organization and structure of dreams before and after acute myocardial infarction are lacking. Methods: We retrospectively studied dream patterns before and after acute myocardial infarction (AMI) in the STEP-IN AMI (Short TErm Psychotherapy IN Acute Myocardial Infarction) trial. We also tried to describe if and how this pattern may change during an ontopsychological short term psychotherapy (STP). A total of 47 patients (pts), who were randomized to psychotherapy in the STEP IN AMI trial, 31 to 70 years old (mean age 54.89), were analyzed. Results: The number of pts able to remember dreams at baseline were 25/47 (53%), and increased to 43/47 (91%) with psychotherapy (P<0.0001). Recurring dreams, referred as a state of anguish, despair, the perception of an inability to complete an action, or the grief of own mother’s early death, in the years before infarction were 34% (16/47 pts). After the third psychotherapeutic session no-one pt had recurring dreams (P<0.001). In the year before AMI it is possible to observe that: 12 of the 25 symbols listed were referred to people known to the pts, and died of a cardiac disease; 9 of 25 symbols reported were referred to an accident, a danger, nightmares and distressing dreams. Globally 21 symbols of 25 seem to highlight a danger for the individual life (84%). The incidence of “negative” symbols sharply reduced during psychotherapy (from 84% to 32% during the first 3 psychotherapeutic sessions and to 9% in the last phase of psychotherapy (P<0.0001). Conclusions: On the basis of these results it is possible to hypothesize that: 1) the high percentage of pts not remembering dreams before AMI may be expression of a censure and psychic repression; 2) the high percentage of symbols of people dead of a cardiac disease and symbols of an accident, a danger, nightmares and distressing dreams in the year before AMI might indicate that dreams are connected to the biological status of the dreamer, warning in advance of months the dreamer of his dreadful cardiac condition; 3) the progressive increase of the ability of the pts to remember dreams during psychotherapy, the cessation of recurrent distressing dreams and the reduction of the incidence of “negative” symbols during psychotherapy strengthens the fact that psychotherapy acted as a positive stimulus for an inner personal change of the pts.