title: Health-related quality of life in patients with anal fissure: effect of type D personality.
abstract: BACKGROUND
  Health-related quality of life (HRQL) is a significant factor in describing the burden of illness and the impact of treatment in patients with gastrointestinal disease. Type D (distressed) personality is defined as the co-occurrence of negative affect and social inhibition.
  
  
  OBJECTIVE
  To assess the prevalence of type D personality in patients with anal fissure and to investigate whether the presence of a type D personality would affect HRQL in patients with anal fissure.
  
  
  METHODS
  One hundred outpatients with anal fissure with no psychiatric comorbidity were consecutively enrolled, along with 100 healthy controls. Type D Scale (DS14) and General Health Survey Short Form-36 (SF-36) were used in the collection of data.
  
  
  RESULTS
  Patients with anal fissure scored lower on physical roles and bodily pain dimensions of SF-36 than healthy subjects (p < 0.05). Thirty-three patients with anal fissure (33%) and 16 controls (16%) had scored above the cut-off score of the DS14 (p < 0.05). Patients with a type D personality were found to score lower on bodily pain and social roles domains of HRQL than patients without a type D personality.
  
  
  CONCLUSIONS
  Type D personality was associated with increased perceived bodily pain and social roles in patients with anal fissure. Type D personality construct may be an important consideration when assessing HRQL outcomes. A multidimensional approach may be valuable in the assessment of patients presenting with anal fissure, because a subgroup with type-D personality might benefit from psychological therapies.
authors: Department of General Surgery, Abant Izzet Baysal University, School of Medicine, Bolu, Turkey.
authors: Mustafa
authors: M
authors: Sit
authors: Department of General Surgery, Abant Izzet Baysal University, School of Medicine, Bolu, Turkey.
authors: Edip Erdal
authors: EE
authors: Yilmaz
authors: Psychiatry Clinic, Bolu Izzet Baysal Mental Health Hospital, Bolu, Turkey.
authors: Fatih
authors: F
authors: Canan
authors: Department of Psychiatry, Abant Izzet Baysal University, School of Medicine, Bolu, Turkey.
authors: Osman
authors: O
authors: Yildirim
authors: General Surgery Clinic, Agri State Hospital, Agri, Turkey.
authors: Mehmet Mustafa
authors: MM
authors: Cetin
keywords: anal fissure; negative affect; quality of life; social inhibition; type D personality