Dream Patterns in Patients with Acute Myocardial Infarction - Data from the STEP-IN-AMI Trial

Q: What does the STEP-IN-AMI trial study about dreams in acute myocardial infarction patients?

It examines dream organization and structure before and after AMI, and how dream patterns change during ontopsychological short-term psychotherapy (STP) after AMI.

Q: How did dream recall change after psychotherapy in the study?

At baseline, 45% of patients remembered dreams, which increased to 91% with psychotherapy (p < 0.0001).

Q: What happened to recurring and negative dream content after STP?

Recurring dreams occurred before AMI in 24% of patients but were reported by no patients after the third psychotherapy session (p < 0.001). The incidence of negative symbols fell from 84% to 32% in the first three sessions and to 9% in the last phase (p < 0.0001).

Sep 30, 2026

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Background: Studies on the organization and structure of dreams before and after acute myocardial infarction (AMI) are lacking. Methods: This retrospective STEP-IN-AMI trial examined dream patterns before and after AMI and analyzed changes during ontopsychological short-term psychotherapy (STP) after AMI. Forty-seven patients aged 31–70 were studied. Results: Dream recall increased from 45% at baseline to 91% with psychotherapy (p < 0.0001). Recurring negative dreams disappeared after the third session, and negative symbols dropped sharply, from 84% to 32% in the first sessions, to 9% in the final phase (p < 0.0001). Conclusions: STP substantially improves dream recall and reduces distressing dream incidence in AMI patients.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

1. Introduction

Article Dream Patterns in Patients with Acute Myocardial Infarction: Data from the STEP-IN-AMI Trial Adriana Roncella 1,2, *, Vincenzo Pasceri 1, Christian Pristipino 1,3, Loreta Di Michele 4, Diego Irini 1, Robert Allan 5, Francesco Pelliccia 6 and Giulio Speciale 1 Academic Editors: Michele Roccella and Stéphane Bouchard Received: 2 November 2025 Revised: 21 December 2025 Accepted: 24 December 2025 Published: 27 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Intensive and Interventional Cardiology Unit, San Filippo Neri Hospital, 00135 Rome, Italy; [vpasceri@hotmail.it](vpasceri@hotmail.it) (V.P.); [pristipino.c@gmail.com](pristipino.c@gmail.com) (C.P.); [giulio.speciale@aslroma1.it](giulio.speciale@aslroma1.it) (G.S.) 2 International Association of Ontopsychology, Via Fontanarosa 25, 00177 Rome, Italy 3 Institut Coeur Paris Centre, 75004 Paris, France 4 San Camillo-Forlanini Hospital, 00152 Rome, Italy; [dottoressadimichele@gmail.com](dottoressadimichele@gmail.com) 5 Division of Cardiology, Weill Cornell Medicine, New York, NY 10065, USA; [cardiacpsych@msn.com](cardiacpsych@msn.com) 6 Department of Cardiovascular Sciences, University Sapienza, 00185 Rome, Italy; [f.pelliccia@mclink.it](f.pelliccia@mclink.it) * Correspondence: [adrianaronella68@gmail.com](adrianaronella68@gmail.com); Tel.: +39-3476890950 Abstract Background: Studies on the organization and structure of dreams before and after acute myocardial infarction (AMI) are lacking. Methods: We retrospectively studied dream patterns before and after AMI in the STEP-IN-AMI trial (Short-TErm Psychotherapy IN Acute Myocardial Infarction) . We also performed an analysis to describe how this pattern may change during ontopsychological short-term psychotherapy (STP) performed after AMI. Forty-seven patients (pts) aged 31–70 were studied. Results: At baseline, 21/47 (45%) pts remembered dreams, which increased to 43/47 (91%) with psychotherapy (p < 0.0001) . Recurring dreams, described as a state of anguish, despair, perceived inability to complete an action, or grief over one’s mother’s early death, occurred before AMI in 16/47 pts (24%) . After the third psychotherapy session, no pts reported recurring dreams (p < 0.001) . In dreams that occurred during the year before AMI, 12 of 25 symbols referred to people known to pts and who had died of a cardiac disease; 9 of 25 symbols referred to an accident, danger, or distressing events. Overall, 21 of 25 symbols were associated with danger to an individual’s life (84%) . The incidence of “negative” symbols was sharply reduced during psychotherapy, from 84% to 32% during the first three psychotherapy sessions and to 9% in the last phase of psychotherapy (p < 0.0001) . Conclusions: Our study is the very first on dreams in pts with AMI, and it also examines how STP may change dream patterns in this cohort of pts. AMI pts frequently do not remember dreams that occurred before AMI or report distressing dreams. STP after AMI significantly increased their ability to remember dreams and sharply reduced the incidence of negative/distressing dreams. The results suggest that (1) dream symbols may be connected to the biological status of the dreamer, warning the dreamer of their cardiac condition; (2) ontopsychological STP may act as a stimulus for inner personal change for AMI pts. Keywords: ontopsychology; dream analysis; ischemic heart disease; acute myocardial infarction 1. Introduction Although sleep has often been considered a beneficial period of restoration and wellbeing, it may significantly impact biological functions [1] . In particular, quality of sleep has been associated with cardiac events [2], and irregular sleep has been associated with subclinical atherosclerosis [3] . Emotional stress represents a trigger for ac

FAQs

What does the STEP-IN-AMI trial study about dreams in acute myocardial infarction patients?

It examines dream organization and structure before and after AMI, and how dream patterns change during ontopsychological short-term psychotherapy (STP) after AMI.

How did dream recall change after psychotherapy in the study?

At baseline, 45% of patients remembered dreams, which increased to 91% with psychotherapy (p < 0.0001).

What happened to recurring and negative dream content after STP?

Recurring dreams occurred before AMI in 24% of patients but were reported by no patients after the third psychotherapy session (p < 0.001). The incidence of negative symbols fell from 84% to 32% in the first three sessions and to 9% in the last phase (p < 0.0001).

Sep 30, 2026

Uploaded by Guten tag