title: Increased emotional distress in type-D cardiac patients without a partner.
abstract: OBJECTIVE
  The distressed (type D) personality is an emerging risk factor in coronary artery disease that has been associated with adverse prognosis, impaired health status, and emotional distress. Little is known about factors that may influence the impact of type-D personality on health outcomes. Therefore, the aim of this study was to determine the combined effect of type-D and not having a partner on symptoms of anxiety and depression.
  
  
  METHODS
  Patients (n=554) hospitalized for acute myocardial infarction or implantable cardioverter defibrillator implantation completed the 14-item type-D Scale (DS14) during hospitalization and the State-Trait Anxiety Inventory and Beck Depression Inventory at 2 months follow-up.
  
  
  RESULTS
  Stratifying by personality and partner status showed that type-D patients without a partner had a higher risk of both anxiety [odds ratio (OR)=8.27; 95% confidence interval (CI)=2.50-27.32] and depressive symptoms (OR=6.74; 95% CI=2.19-20.76) followed by type-D patients with a partner (OR=3.73; 95% CI=2.16-6.45 and OR=3.81; 95% CI=2.08-6.99, respectively) and non-type-D patients without a partner (OR=2.04; 95% CI=1.05-3.96 and OR=3.03; 95% CI=1.46-6.31, respectively) compared to non-type-D patients with a partner, adjusting for demographic and clinical baseline characteristics, indicating a dose-response relationship.
  
  
  CONCLUSIONS
  Lack of a partner further exacerbated the risk of symptoms of anxiety and depression in the already distressed type-D patients. In clinical practice, it is important to identify type-D patients without a partner and carefully monitor them, as they may be less likely to alter health-related behaviors due to their increased levels of distress.
authors.affiliation: CoRPS-Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, and Department of Cardiology, Catharina Hospital Eindhoven, The Netherlands. c.c.l.t.vdnbroek@uvt.nl
authors.forename: Krista C
authors.initials: KC
authors.lastname: van den Broek
authors.forename: Elisabeth J
authors.initials: EJ
authors.lastname: Martens
authors.forename: Ivan
authors.initials: I
authors.lastname: Nyklícek
authors.forename: Pepijn H
authors.initials: PH
authors.lastname: van der Voort
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
mesh_terms: D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology*; D015897:Comorbidity; D017147:Defibrillators, Implantable / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology*; D009426:Netherlands; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012307:Risk Factors; D012803:Sick Role; D012847:Single Person / Q000523:psychology*; D013694:Temperament