Type D personality and depressive symptoms are independent predictors of impaired health status following acute myocardial infarction

Floortje Mols ^1*, Elisabeth J Martens ¹ and Johan Denollet ¹

¹ Tilburg University, Netherlands

^* To whom correspondence should be addressed. E-mail: f.mols{at}uvt.nl.

Accepted 15 September 2009

Abstract

Objective: In this prospective follow-up study we investigated whether the Type D personality construct (the tendency to experience negative emotions and to be socially inhibited) exerts an independent effect on disease-specific health status in post-myocardial infarction (MI) patients, after adjustment for disease severity and depressive symptoms.

Methods: Patients (n=503) were assessed on demographic and clinical variables and completed the Type D Scale (DS14) and Beck Depression Inventory (BDI) within the first week of hospital admission for acute MI. Two months post-MI, all patients completed the CIDI interview. After 18-months, they filled out the Seattle Angina Questionnaire (SAQ) to assess disease-specific health status.

Results: At follow-up, Type D patients had significantly lower mean scores on all SAQ subscales, indicating worse disease-specific health status, as compared to non-Type D patients (all p-values <0.01). After adjustment for disease severity and depression in multivariate analysis, Type D patients still had more physical limitations (mean SAQ score: 49 versus 54; p=0.014), less angina stability (62 versus 71; p=0.002) and a less accurate disease perception (52 versus 61; p=<0.001) compared with non-Type D patients. Depressed patients (BDI10) also reported significantly lower SAQ scores compared to non-depressed patients.

Conclusions: The Type D construct is an independent predictor of impaired disease-specific health status. Type D personality, in addition to depression, may thus be an important psychological factor that deserves attention during the period of rehabilitation in post-MI patients.