title: A comparison of psychosocial risk factors between 3 groups of cardiovascular disease patients referred for outpatient cardiac rehabilitation.
abstract: OBJECTIVE
  Few studies have examined psychosocial risk factors for cardiovascular disease (CVD) between diagnostic groups of CVD patients. We compared levels of depression, anxiety, hostility, exhaustion, positive affect, and social support, and the prevalence of type D personality between patient groups with a primary diagnosis of coronary heart disease (CHD), chronic heart failure (CHF), or peripheral arterial disease (PAD).
  
  
  METHODS
  We examined 548 CHD patients, 105 CHF patients, and 79 PAD patients who completed the Hospital Anxiety and Depression Scale, the cynical hostility subscale of the Minnesota Multiphasic Personality Inventory-2, the short form of the Maastricht Vital Exhaustion Questionnaire, the type D personality questionnaire, the positive mood scale of the Global Mood Scale, and the Enhancing Recovery in CHD Social Support Inventory, all in the first week of cardiac rehabilitation. Group differences in psychosocial factors were adjusted for sociodemographic factors, previous myocardial infarction, traditional cardiovascular risk factors, and medications.
  
  
  RESULTS
  Relative to patients with PAD, those with CHD and those with CHF both showed greater exhaustion (P ≤ .001) and lower positive affect (P ≤ .03). The effect sizes of these differences were clinically relevant (Cohen's d between 0.32 and 0.49). There were no significant differences in psychosocial risk factors between CHD and CHF patients.
  
  
  CONCLUSIONS
  The profile of psychosocial risk factors for CVD revealed clinically relevant variability between different diagnostic groups of CVD patients. The findings imply that patients with distinct cardiac diagnosis might additionally benefit from comprehensive cardiac rehabilitation if the program includes psychosocial risk factor-specific interventions.
authors.affiliation: Department of General Internal Medicine, Division of Psychosomatic Medicine, Inselspital, Bern University Hospital and University of Bern, Switzerland.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Stauber
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Schmid
authors.forename: Hugo
authors.initials: H
authors.lastname: Saner
authors.forename: Gaby
authors.initials: G
authors.lastname: Saner
authors.forename: Johannes
authors.initials: J
authors.lastname: Grolimund
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
mesh_terms: D000223:Adaptation, Psychological; D000339:Affect; D001007:Anxiety; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000523:psychology; D016009:Chi-Square Distribution; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D005222:Mental Fatigue; D008875:Middle Aged; D015999:Multivariate Analysis; D010045:Outpatients; D011594:Psychometrics; D012017:Referral and Consultation; D012307:Risk Factors; D012944:Social Support; D013223:Statistics as Topic; D013315:Stress, Psychological; D011795:Surveys and Questionnaires