Type D personality and depressive symptoms are independent predictors of impaired health status following acute myocardial infarction.
OBJECTIVE
In this prospective follow-up study we investigated whether the type D personality construct (the tendency to experience negative emotions and to be socially inhibited) exerts an independent effect on disease-specific health status in post-myocardial infarction (MI) patients, after adjustment for disease severity and depressive symptoms.


METHODS
Patients (n = 503) were assessed on demographic and clinical variables and completed the type D scale (DS14) and Beck Depression Inventory (BDI) within the first week of hospital admission for acute MI. Two months post-MI, all patients completed the WHO Composite International Diagnostic Interview (CIDI) interview. After 18 months, they filled out the Seattle Angina Questionnaire (SAQ) to assess disease-specific health status.


RESULTS
At follow-up, type D patients had significantly lower mean scores on all SAQ subscales, indicating worse disease-specific health status, compared to non-type D patients (all p values <0.01). After adjustment for disease severity and depression in multivariate analysis, type D patients still had more physical limitations (mean SAQ score: 49 versus 54; p = 0.014), less angina stability (62 versus 71; p = 0.002) and a less accurate disease perception (52 versus 61; p < or = 0.001) compared with non-type D patients. Depressed patients (BDI > or = 10) also reported significantly lower SAQ scores compared to non-depressed patients.


CONCLUSIONS
The type D construct is an independent predictor of impaired disease-specific health status. Type D personality, in addition to depression, may thus be an important psychological factor that deserves attention during the period of rehabilitation in post-MI patients.
CoRPS, Department of Medical Psychology and Neuropsychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE Tilburg, The Netherlands. f.mols@uvt.nl
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F
Mols
E J
EJ
Martens
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J
Denollet
D001008:Anxiety Disorders / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000523:psychology*; D009341:Negativism; D011446:Prospective Studies