title: Type D personality is associated with impaired health-related quality of life 7 years following heart transplantation.
abstract: OBJECTIVE
  Health-related quality of life (HRQoL) following transplantation is gaining importance as an endpoint, but little is known about the role of normal personality traits as a determinant of HRQoL in this patient group. We investigated whether Type D personality (tendency to experience increased negative emotions paired with the nonexpression of these emotions) was associated with impaired HRQoL in heart transplant recipients.
  
  
  METHODS
  Data were collected from all surviving heart transplant recipients >or=21 years of age (n=186) with a mean (S.D.) of 7 (5) years following transplantation. Patients completed the Short-Form Health Survey 36 (SF-36) and the Type D Scale (DS14). Clinical data were obtained from the medical records.
  
  
  RESULTS
  Of the 186 patients, 18% had a Type D personality. Type D patients had significantly worse scores on the Physical Component scale (PCS) (P=.04) and the Mental Component scale (MCS) (P<.001) of the SF-36 and all the SF-36 subdomains (all P<.01) compared with non-Type D patients, except for Bodily Pain. Type D personality remained an independent determinant of impaired PCS [odds ratio (OR), 3.62; 95% confidence interval (CI), 1.25-10.45] and MCS (OR, 6.13; 95% CI, 2.23-16.83) and six of the eight subscales of the SF-36, adjusting for demographic and clinical characteristics.
  
  
  CONCLUSIONS
  Type D personality was associated with more than a three- to six-fold increased risk of impaired HRQoL in heart transplant recipients, showing that the Type D personality construct also has value in heart transplant recipients. The adoption of a personality approach may lead to improved risk stratification in research and clinical practice in this patient group.
authors.affiliation: Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands. s.s.pedersen@uvt.nl
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
authors.forename: Pieter G
authors.initials: PG
authors.lastname: Holkamp
authors.forename: Kadir
authors.initials: K
authors.lastname: Caliskan
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: Ruud A M
authors.initials: RA
authors.lastname: Erdman
authors.forename: Aggie H M M
authors.initials: AH
authors.lastname: Balk
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D016027:Heart Transplantation / Q000401:mortality / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality; D010809:Physical Fitness; D011788:Quality of Life; D012959:Socioeconomic Factors; D016019:Survival Analysis; D013997:Time Factors