title: Type D personality as a cardiovascular risk marker in the general population: results from the Gutenberg health study.
abstract: BACKGROUND
  Type D personality is considered as an independent risk factor for morbidity and mortality in cardiovascular patients and a vulnerability factor for distress in the general population. Because representative community studies are rare, we sought to determine the prevalence of type D personality and its relationship with demographic characteristics, different features of mental disorders, cardiovascular risk factors, health behavior, endothelial function and cardiovascular biomarkers in the general population.
  
  
  METHODS
  The prevalence of type D personality and its correlates were analyzed cross-sectionally in a population-based sample of 5,000 Mid-Europeans aged 35-74 years from the Gutenberg Health Study.
  
  
  RESULTS
  The prevalence of type D personality was 22.2% without remarkable differences in sex distribution. Type D subjects were characterized by lower socioeconomic status, lack of a partnership, increased depression, anxiety, depersonalization and health care utilization. Despite its strong association with mental disorders, type D personality emerged as psychometrically distinct. Although type D personality was independently associated with coronary heart disease (OR = 1.54, p = 0.044), no associations with traditional cardiovascular risk factors were found independently from depression or anxiety.
  
  
  CONCLUSIONS
  Although type D personality is strongly associated with depression, anxiety, impaired mental and somatic health status, and increased health care utilization, the type D construct seems to comprise dysfunctional personality patterns not covered by depression and anxiety scales. Beyond these associations, the pathways of the cardiotoxic impact of type D personality remain to be elucidated. There is a need for prospective population studies on potential links between type D personality and cardiac disease.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
authors.forename: M E
authors.initials: ME
authors.lastname: Beutel
authors.forename: J
authors.initials: J
authors.lastname: Wiltink
authors.forename: Y
authors.initials: Y
authors.lastname: Till
authors.forename: P S
authors.initials: PS
authors.lastname: Wild
authors.forename: T
authors.initials: T
authors.lastname: Münzel
authors.forename: F M
authors.initials: FM
authors.lastname: Ojeda
authors.forename: T
authors.initials: T
authors.lastname: Zeller
authors.forename: R B
authors.initials: RB
authors.lastname: Schnabel
authors.forename: K
authors.initials: K
authors.lastname: Lackner
authors.forename: M
authors.initials: M
authors.lastname: Blettner
authors.forename: I
authors.initials: I
authors.lastname: Zwiener
authors.forename: M
authors.initials: M
authors.lastname: Michal
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology*; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology; D004727:Endothelium / Q000503:physiopathology; D005260:Female; D005858:Germany / Q000453:epidemiology; D015438:Health Behavior; D006801:Humans; D007406:Interview, Psychological; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010551:Personality; D010552:Personality Assessment; D010554:Personality Disorders / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000453:epidemiology
chemical_list: D015415:Biomarkers