Symptoms of fatigue and depression in ischemic heart disease are driven by personality characteristics rather than disease stage: a comparison of CAD and CHF patients.
BACKGROUND
Symptoms of fatigue and depression are prevalent across stages of ischemic heart disease (IHD). We examined (i) the effect of both the IHD stage and type-D personality on fatigue and depressive symptoms at 12-month follow-up, and (ii) whether the effect of type-D personality on these symptoms is moderated by IHD stage.


METHODS
Two different samples of patients were included to represent IHD stage: 401 percutaneous coronary intervention patients (early-stage IHD) and 105 ischemic chronic heart failure patients (end-stage IHD) completed the DS14 Type-D Scale at baseline. Logistic regression analysis was used to examine the impact of IHD stage and type-D personality on fatigue and depression at follow-up.


RESULTS
Disease stage was neither associated with symptoms of fatigue (P=0.99) nor depression (P=0.29) at 12 months. In contrast, type-D personality was shown to predict both symptoms of fatigue [odds ratio (OR)=2.96; 95% confidence interval (CI): 1.92-4.58, P<0.001] and depression (OR=4.91; 95% CI: 3.16-7.65, P<0.001) at follow-up; the effect of type-D personality on these symptoms was not moderated by disease stage. In multivariable analysis, type-D remained a significant predictor of symptoms of fatigue (OR=3.14; 95% CI: 1.98-4.99, P<0.001) and depression (OR=5.90; 95% CI: 3.60-9.67, P<0.001), also after controlling for symptom levels at baseline.


CONCLUSIONS
Type-D personality but not disease stage predicted symptoms of fatigue and depression at 12-month follow-up.
Smith
Otto R F
OR
CoRPS - Center of Research for Psychology on Somatic diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands. robert.smith@psy-uvt.nl
Pedersen
Susanne S
SS
Van Domburg
Ron T
RT
Denollet
Johan
J
D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications* / Q000523:psychology; D003863:Depression / Q000209:etiology*; D018450:Disease Progression; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000523:psychology; D016017:Odds Ratio; D010551:Personality; D012189:Retrospective Studies; D013997:Time Factors