title: Type D personality is independently associated with major psychosocial stressors and increased health care utilization in the general population.
abstract: BACKGROUND
  Type D is considered as a non pathological personality trait and propensity for mental distress. Its relationship with mental distress has been mainly studied in cardiovascular patients and with respect to depression. The knowledge about the relationship of Type D with mental disorders, psychosocial stressors and health care utilization in the general population is insufficient. Therefore the present study sought to determine the associations of Type D with mental distress, major psychosocial stressors, health status, and health care utilization in the general population.
  
  
  METHODS
  Cross-sectional analysis in a representative population based sample of n = 2495 subjects (mean age 49 years, range 14-92 years) of whom 33.1% had Type D personality.
  
  
  RESULTS
  Individuals with Type D had an increased risk for clinically significant depression, panic disorder, somatization and alcohol abuse. After adjustment for these mental disorders Type D was still robustly associated with all major psychosocial stressors. The strongest associations emerged for feelings of social isolation and for traumatic events. After comprehensive adjustment Type D still remained associated with increased help seeking behavior and utilization of health care, especially of mental health care.
  
  
  CONCLUSIONS
  The main limitation is the reliance on self-report measures and the lack of information about the medical history and clinical diagnosis of the participants.
  
  
  CONCLUSIONS
  Type D identifies persons with severely increased risk for mental distress, major psychosocial stressors and increased health care utilization. As a frequent disposition, Type D is assumed to be of high relevance for health care.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Michal
authors.forename: Jörg
authors.initials: J
authors.lastname: Wiltink
authors.forename: Gesine
authors.initials: G
authors.lastname: Grande
authors.forename: Manfred E
authors.initials: ME
authors.lastname: Beutel
authors.forename: Elmar
authors.initials: E
authors.lastname: Brähler
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism; D003430:Cross-Sectional Studies; D003863:Depression; D003866:Depressive Disorder; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D010551:Personality / Q000145:classification*; D010554:Personality Disorders; D012917:Social Adjustment; D013001:Somatoform Disorders; D013315:Stress, Psychological; D055815:Young Adult