title: Type D personality, mental distress, social support and health-related quality of life in coronary artery disease patients with heart failure: a longitudinal observational study.
abstract: BACKGROUND
  The relationship between Type D personality and health related quality of life (HRQoL) in coronary artery disease patients is becoming more established, however, the factors that may explain this association remain unclear. The objective of the study was to examine the mediating effects of mental distress and social support on the relationship between the Type D personality and HRQoL in CAD patients with heart failure.
  
  
  METHODS
  A total of 855 CAD patients with heart failure were assessed on Type D personality, mental distress, perceived social support and HRQoL with the following self-administered questionnaires: the Type D personality scale - 14, the Hospital Anxiety and Depression scale, the Multidimensional Scale of Perceived Social Support and the Minnesota Living with Heart Failure Questionnaire.
  
  
  RESULTS
  The prevalence of Type D personality within the study population was 33.5%. Type D personality, anxiety symptoms, depressive symptoms and social support were all found to be determinants of decreased HRQoL (p's < 0.001), once age, gender, NYHA functional class and acute myocardial infarction were adjusted for. Anxiety, depressive symptoms and social support were found to mediate the relationship between Type D personality and HRQoL. Type D personality exerted a stable effect on HRQoL over 24 months follow-up period.
  
  
  CONCLUSIONS
  Type D personality has an independent significant effect on the HRQoL in CAD patients with heart failure, and this relation is mediated by anxiety and depressive symptoms, social support.
authors.affiliation: Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania. mstaniute@ktl.mii.lt.
authors.forename: Margarita
authors.initials: M
authors.lastname: Staniute
authors.affiliation: Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania. jbro@ktl.mii.lt.
authors.forename: Julija
authors.initials: J
authors.lastname: Brozaitiene
authors.affiliation: Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania. julius.burkauskas@lsmuni.lt.
authors.forename: Julius
authors.initials: J
authors.lastname: Burkauskas
authors.affiliation: Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania. nijolekazukauskiene@yahoo.com.
authors.forename: Nijole
authors.initials: N
authors.lastname: Kazukauskiene
authors.affiliation: Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania. narseta.mickuviene@lsmuni.lt.
authors.forename: Narseta
authors.initials: N
authors.lastname: Mickuviene
authors.affiliation: Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania. rob@ktl.mii.lt.
authors.forename: Robertas
authors.initials: R
authors.lastname: Bunevicius
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008097:Lithuania / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires; D064415:Type D Personality