title: Type D personality is associated with increased comorbidity burden and health care utilization among 3080 cancer survivors.
abstract: OBJECTIVE
  Cancer survivors often report comorbid diseases, but there are individual differences in risk. Type D personality is a general propensity to psychological distress that is related to poor cardiovascular outcomes. In this study, we examined whether type D was also related to comorbidity burden and health care utilization among cancer survivors.
  
  
  METHODS
  Individuals diagnosed with endometrial cancer or colorectal cancer between 1998 and 2007, or with lymphoma or multiple myeloma between 1999 and 2008 as registered in the Eindhoven Cancer Registry, received the Self-Administered Comorbidity Questionnaire, questions on health care utilization and the Type D personality scale; 69% (n=3080) responded.
  
  
  RESULTS
  Nineteen percent of survivors had a type D personality. Over a 12-month period, type D survivors significantly more often reported osteoarthritis, back pain, and depression than non-type D survivors. Also, type D survivors more often reported to feel bothered by high blood pressure, osteoarthritis, heart disease, depression, diabetes and lung disease during daily activities. Type D survivors more often visited their general practitioner than non-type D survivors (P<.001), also in relation to cancer (0 visits: 54% vs. 60%; 1-5: 28% vs. 22%; >5: 9% vs. 5%; P<.001), as well as their specialist (0 visits: 6% vs. 7%; 1-5 visits: 59% vs. 64%; >5 visits: 30% vs. 23%; P<.01).
  
  
  CONCLUSIONS
  Type D personality is a vulnerability factor that may help to identify subgroups of cancer survivors who are at an increased risk for comorbidity burden and increased health care utilization.
authors.affiliation: Center of Research on Psychology in Somatic Diseases, Department of Medical Psychology and Neuropsychology, Tilburg University, Tilburg, The Netherlands. F.Mols@uvt.nl
authors.forename: Floortje
authors.initials: F
authors.lastname: Mols
authors.forename: Simone
authors.initials: S
authors.lastname: Oerlemans
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
authors.forename: Jan-Anne
authors.initials: JA
authors.lastname: Roukema
authors.forename: Lonneke V
authors.initials: LV
authors.lastname: van de Poll-Franse
mesh_terms: D000368:Aged; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010551:Personality; D010553:Personality Development; D017741:Survivors / Q000523:psychology*