title: Shock and patient preimplantation type D personality are associated with poor health status in patients with implantable cardioverter-defibrillator.
abstract: BACKGROUND
  Implantable cardioverter-defibrillator (ICD) shock is a critical event to patients associated with well-being after implantation, although other factors may play an equally important role. We compared the association of shock and the patient's preimplantation personality with health status, using a prospective study design.
  
  
  RESULTS
  Consecutively implanted ICD patients (n=383; 79% men) completed the Type D Scale at baseline and the Short-Form Health Survey 36 (SF-36) at baseline and 3, 6, and 12 months. Of all patients, 23.5% had a Type D personality and 13.8% received a shock during follow-up. Shocked patients reported significantly poorer health status, as did Type D patients. Health status patterns were poorest in patients with combined Type D personality and shock during follow-up. Shock during follow-up was a significant independent associate of poorer health status for 4 of 8 subscales of the SF-36 and the Mental Component Summary (all P<.05), with shocked patients scoring between 2.60 to 13.30 points lower than nonshocked patients. Type D personality was an independent associate of poor postimplantation health status for 6 of 8 of the SF-36 subscales and the Mental Component Summary, with Type D patients scoring between 2.12 to 8.02 points lower, adjusting for demographic and clinical characteristics.
  
  
  CONCLUSIONS
  ICD shock and the patient's preimplantation personality disposition were equally important associates of health status 12 months after implantation. Identification of the patient's personality profile before ICD implantation may help identify subsets of patients who may need additional care, for example, with a psychosocial component.
authors.affiliation: CoRPS, Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands. s.s.pedersen@uvt.nl
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
authors.forename: Fetene B
authors.initials: FB
authors.lastname: Tekle
authors.forename: Madelein T
authors.initials: MT
authors.lastname: Hoogwegt
authors.forename: Luc
authors.initials: L
authors.lastname: Jordaens
authors.forename: Dominic A M J
authors.initials: DA
authors.lastname: Theuns
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D016009:Chi-Square Distribution; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000009:adverse effects / Q000295:instrumentation* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010551:Personality; D010552:Personality Assessment; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D018570:Risk Assessment; D012307:Risk Factors; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome