title: The Clinical Link between Type D Personality and Diabetes.
abstract: BACKGROUND
  Type D personality consists of a mixture of high levels of negative affectivity and social inhibition, resulting in a stable tendency to experience negative emotions, by inhibiting the expression of these emotions. We have reanalyzed the clinically relevant studies examining the role of this personality profile in diabetes, by providing a qualitative synthesis of the data. In this regard, the aim of this study is to provide a systematic review by evaluating the clinical link between Type D personality and diabetes.
  
  
  METHODS
  When focusing on PRISMA guidelines, we have performed a comprehensive research of the literature on PubMed, Scopus, ScienceDirect, ISI Web of Science, PsycINFO, and Google Scholar by using search terms as "distressed personality" OR (i.e., Boolean operator) "Type D personality" combined with the Boolean "AND" operator with "diabetes."
  
  
  RESULTS
  A total of seven research studies were identified and included in the review. Type D was found to be more prevalent in diabetes patients than controls. As regards the specific association with diabetes variables, Type D personality is a significant predictor of both poor medication adherence and unhealthy behaviors, by predicting negative mental health consequences also (i.e., depressed mood, anhedonia, and anxiety).
  
  
  CONCLUSIONS
  Our review emphasized for the first time that Type D personality affects clinical factors in patients with diabetes by provoking adverse outcomes. The core implication of the study comprises the clinical relevance to detect, from a clinimetric point of view, Type D personality in diabetes in order to prevent potentially negative clinical outcomes.
authors.affiliation: Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara , Chieti , Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Conti
authors.affiliation: Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Hillerød, Denmark.
authors.forename: Danilo
authors.initials: D
authors.lastname: Carrozzino
authors.affiliation: Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara , Chieti , Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Patierno
authors.affiliation: Department of Medicine and Aging, University "G. d'Annunzio" of Chieti-Pescara , Chieti , Italy.
authors.forename: Ester
authors.initials: E
authors.lastname: Vitacolonna
authors.affiliation: Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara , Chieti , Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Fulcheri
keywords: Type D personality; adherence; clinimetrics; diabetes; distressed personality