Background Controversy still exists over the independent role of psychosocial factors in acute myocardial infarction (AMI). This study aimed to compare psychometric indices in Portuguese patients surviving a first episode of AMI and a community sample free of AMI.Design A community-based, case-control study. The study sample included 153 male patients with a first episode of AMI and 156 male controls randomly selected from the community.Methods Information on demographic, social, medical and behavioural characteristics was obtained using a structured questionnaire; anthropometric, blood pressure, and serum measurements were performed, and the psychometric evaluation was obtained using a self-evaluation questionnaires (Bortner scale, Beck Depression Inventory, SCL-90-R, Psychological General Well-Being and the Nottingham Health Profile).Results Cases of AMI more often exhibited type A behaviour (15.4 ± 3,0 versus 14.7 ± '2.7, p= 0.041), had more depressive symptoms (1 0.8 ± 8.0 versus 8.6 ± 8.0, P= 0.005) and showed worse scores on general well-being (68.4 ± 17.7 versus 76.6± 16.'2, P< 0.00 l) than controls. Cases were significantly different from controls in terms of years of education (6.7 ± 4.4 versus 9.0±4.7 years, P