title: Prognostic value of type D personality for 10-year mortality and subjective health status in patients treated with percutaneous coronary intervention.
abstract: OBJECTIVE
  Given the debate around limitations and controversies in type D personality studies, we aimed to evaluate the prognostic value of 'synergistically' analyzed type D personality (interaction z-scores negative affectivity NA, and social inhibition SI) on 10-year mortality and on 10-year subjective health status in percutaneous coronary intervention (PCI) patients.
  
  
  METHODS
  This prospective study comprised a cohort of 1190 consecutive patients who underwent PCI between October 2001 and September 2002 (73% male, mean age: 62years, range [27-90]years). At baseline, type D personality (DS14), and depression/anxiety (HADS) were assessed. Primary endpoint was 10year all-cause mortality; secondary endpoint was 10-year subjective health status (SF-36).
  
  
  RESULTS
  After a median follow-up of 10.3years (IQR 9.8-10.8), 293 deaths of any cause (24.6%) were recorded. After adjustment for significant baseline characteristics, personality categories approached and dichotomously approached type D personality were associated with 10-year mortality, p<.05. Synergistically approached type D personality was not associated with all-cause mortality or subjective health status at 10years. In survivors, higher NA was associated with lower subjective health status. Type D was not associated with mortality after adjusting for continuous depression and anxiety in all approaches.
  
  
  CONCLUSIONS
  Synergistically analyzed type D was not associated with 10-year all-cause mortality in PCI patients whereas dichotomous type D was. However, after adjustment for depression most of the findings had disappeared. Depression played an important role in this. Type D was not associated with 10-year subjective health status.
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Dulfer
authors.affiliation: Department of Cardiology - Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: B A F
authors.initials: BA
authors.lastname: Hazemeijer
authors.affiliation: Department of Cardiology - Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: M R
authors.initials: MR
authors.lastname: Van Dijk
authors.affiliation: Department of Cardiology - Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: R J M
authors.initials: RJ
authors.lastname: Van Geuns
authors.affiliation: Department of Cardiology - Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Daemen
authors.affiliation: Department of Cardiology - Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. Electronic address: r.vandomburg@erasmusmc.nl.
authors.forename: R T
authors.initials: RT
authors.lastname: Van Domburg
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: E M W J
authors.initials: EM
authors.lastname: Utens
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D003863:Depression; D059026:Diagnostic Self Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D062645:Percutaneous Coronary Intervention; D010551:Personality; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D064415:Type D Personality
keywords: Depression; Mortality; Percutaneous coronary intervention; Subjective health status; Type D personality