title: 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.
abstract: 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.
authors.affiliation: CoRPS - Center of Research for Psychology on Somatic diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands. robert.smith@psy-uvt.nl
authors.forename: Otto R F
authors.initials: OR
authors.lastname: Smith
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
authors.forename: Ron T
authors.initials: RT
authors.lastname: Van Domburg
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
mesh_terms: 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