title: Type D personality is a predictor of poor emotional quality of life in primary care heart failure patients independent of depressive symptoms and New York Heart Association functional class.
abstract: Quality of life is an important patient-centered outcome and predictor of mortality in heart failure, but little is known about the role of personality as a determinant of quality of life in this patient group. We examined the influence of Type D personality (i.e., increased negative emotions paired with emotional non-expression) on quality of life in primary care heart failure patients, using a prospective study design. Heart failure patients (n = 251) recruited from 44 primary care practices in Germany completed standardized questionnaires at baseline and 9 months. The prevalence of Type D was 31.9%. Type D patients experienced poorer emotional (P < .001) and physical quality of life (P = .01) at baseline and 9 months compared to non-Type D patients. There was no significant change in emotional (P = .78) nor physical quality of life (P = .74) over time; neither the interaction for time by Type D for emotional (P = .31) nor physical quality of life (P = .91) was significant, indicating that Type D exerted a stable effect on quality of life over time. Adjusting for demographics, New York Heart Association functional class, and depressive symptoms, Type D remained an independent determinant of emotional (P = .03) but not physical quality of life (P = .29). Primary care heart failure patients with a Type D personality experienced poorer emotional but not physical quality of life compared to non-Type D patients. Patients with this personality profile should be identified in primary care to see if their treatment is optimal, as both Type D and poor quality of life have been associated with increased morbidity and mortality.
authors: CoRPS, Center of Research on Psychology in Somatic diseases, Department of Medical Psychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE Tilburg, The Netherlands. s.s.pedersen@uvt.nl
authors: Susanne S
authors: SS
authors: Pedersen
authors: Christoph
authors: C
authors: Herrmann-Lingen
authors: Peter
authors: P
authors: de Jonge
authors: Martin
authors: M
authors: Scherer
mesh_terms: D000368:Aged; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006333:Heart Failure / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D010551:Personality; D010556:Personality Tests; D015995:Prevalence; D011320:Primary Health Care; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome