Article Text

Download PDFPDF
Acute coronary syndromes
Type D personality and depressive symptoms are independent predictors of impaired health status following acute myocardial infarction
  1. F Mols1,
  2. E J Martens1,2,
  3. J Denollet1
  1. 1
    CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical Psychology, Tilburg University, The Netherlands
  2. 2
    Department of Education and Research, Catharina Hospital Eindhoven, The Netherlands
  1. Correspondence to Dr Floortje Mols, CoRPS, Department of Medical Psychology and Neuropsychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE Tilburg, The Netherlands; f.mols{at}


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 WHO Composite International Diagnostic Interview (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, 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 (BDI ⩾10) 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.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding This research was supported by a VICI grant (#453-04-004) from the Netherlands Organization for Scientific Research (The Hague, The Netherlands) awarded to JD.

  • Competing interests None declared.

  • Provenance and Peer review Not commissioned; externally peer reviewed.