The Effects of Expressive Writing Following First Myocardial Infarction: A Randomized Controlled Trial

Objective: To assess the effects of expressive writing on health care utilization, clinical variables and subjective quality of life following first myocardial infarction (MI). Methods: One-hundred and seventynine first MI patients were randomized to Intervention (N = 88) or Control (N = 91) groups. The intervention group wrote about their thoughts and feelings in relation to having had an MI. Controls wrote in a neutral way about daily activities. The main outcome measures were health care utilization, physical status and subjective quality of life (QOL), assessed after one, two, and five months. Results: One-hundred and fifty-six (87%) completed the study. Five months post-intervention, the intervention group had significantly fewer recorded medical appointments compared to controls. The number of prescribed medicines decreased over time within the intervention group but increased within the control group. The intervention group attended significantly more rehabilitation sessions, reported fewer cardiac related symptoms and had lower diastolic blood pressure five months post-intervention. There was no significant group by time interaction on reported physical health. The group by time interaction on reported mental health approached significance, those in the intervention group reporting greater improvement. Conclusion: Expressive writing may be a beneficial strategy which could be incorporated into rehabilitation interventions to help individuals adjust after first MI.