title: Is type-D a stable construct? An examination of type-D personality in patients before and after cardiac surgery.
abstract: OBJECTIVE
  Type-D personality-negative affectivity and social inhibition-are related to poor prognosis in cardiovascular diseases. At present, little is known about type-D personality and its stability before and after cardiac surgery.
  
  
  METHODS
  One hundred twenty-six patients recommended for coronary bypass and/or valve surgery were examined at pre-surgery and 6 months post-surgery to investigate the stability of type-D (14-item Type-D Scale) and its relationship to anxiety, depression (Hospital Anxiety and Depression Scale) and quality of life (Short Form 12).
  
  
  RESULTS
  Preoperatively, 26% were assessed to have type-D, while only 11% fulfilled type-D criteria both pre- and post-surgery. Patients were assessed and identified as belonging to one of the four type-D groups: Stable type-D (11%), non-type-D (61%), type-D pre (15%), and type-D post (13%). In comparison to the stable non-type D group, the stable type-D reported more symptoms of anxiety, depression, lower physical quality of life post-surgery, and lower mental quality of life both pre- and post-surgery. When compared to the population at large, stable type-D had more symptoms of depression pre-surgery, and more anxiety as well as lower physical and mental quality of life pre- and post-surgery.
  
  
  CONCLUSIONS
  Type-D diagnosis changed in nearly 60% of the cases post-surgery. Only those patients with stable type-D exhibited a relationship to emotional distress, such as anxiety and depression and reduced quality of life. Additional research on the critical cut-off scores and stability of type-D as it relates to critical life events would likely enhance our ability to more effectively diagnose and treat patients who are at high risk for insufficient coping.
authors.affiliation: Department of Psychosomatics and Psychotherapy, Medical Clinic, University Hospital Carl Gustav Carus, Dresden, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dannemann
authors.forename: Klaus
authors.initials: K
authors.lastname: Matschke
authors.forename: Franziska
authors.initials: F
authors.lastname: Einsle
authors.forename: Mervin R
authors.initials: MR
authors.lastname: Smucker
authors.forename: Katrin
authors.initials: K
authors.lastname: Zimmermann
authors.forename: Peter
authors.initials: P
authors.lastname: Joraschky
authors.forename: Kerstin
authors.initials: K
authors.lastname: Weidner
authors.forename: Volker
authors.initials: V
authors.lastname: Köllner
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001021:Aortic Valve / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000523:psychology*; D003327:Coronary Disease / Q000523:psychology* / Q000601:surgery*; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D010553:Personality Development; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D018570:Risk Assessment