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Objective To gain Dutch population norms for the Short Form-12 (SF-12), a generic health status questionnaire, in a random sample of the general population and to validate these in postmyocardial infarction (MI) patients. Methods 2,301 respondents from the general population and 459 post-MI patients completed the Short Form-36 (SF-36), which was used to calculate SF-12 scores. Results The SF-12 summary scores correlated highly with SF-36 summary scores, demonstrating that these scores explain the same amount of variance in health status. Significant sex differences (P \ .001) existed for both the physical component summary (PCS) and the mental component summary (MCS). Multivariate analysis of variance showed a main effect of age in oblique (PCS-12: P \ .001; MCS-12: P \ .001) and orthogonally rotated PCS scores (PCS-12_uc: P \ .001; MCS-12_uc: P = .07). As expected, post-MI patients reported statistically significant and clinically relevant poorer mental (P \ .001) and physical functioning (P \ .001). Differences were less pronounced for MCS and PCS derived from orthogonal rotation data. When controlling for covariates, MI did not significantly affect PCS-12_uc anymore in orthogonally rotated data, while PCS-12_uc was affected by fewer covariates compared with PCS-12. Conclusions This study presents Dutch population norms for the SF-12 in a large random population sample obtained from both oblique and orthogonal PCA rotation methods, revealing systematic differences between the results based on these two methods. Furthermore, this study demonstrates the discriminative validity of the SF-12 by showing that post-MI patients differ significantly from the normative population on PCS-12 scores.

Morbid obesity is associated with an increased risk of morbidity and mortality as well as psychosocial problems and poor quality of life. The ultimate goal of bariatric surgery is not only reduced weight and reduction of co-morbidities, but also improved psychosocial functioning and quality of life. However, not all patients are successful. A systematic literature search of recent articles identified relevant variables reflecting postoperative psychosocial functioning. Most studies showed that bariatric surgery does not only lead to substantial weight reduction, but also to improvement or cure of physical as well as psychological co-morbidities. Although most studies are optimistic and report broad psychosocial improvement, a significant minority of patients do not benefit psychologically from surgery. Although there are mixed results, the overall improvements in psychosocial functioning provide additional justification for surgical treatment of morbid obesity.

Objective: To examine the role of clinical and psychological characteristics as predictors of fatigue in CHF. Background: Little is known about predictors of fatigue in CHF. Next to heart failure characteristics, depressive symptoms and type-D personality may explain individual differences in fatigue. Methods: At baseline, 136 CHF outpatients (age ≤ 80 years) completed a questionnaire to assess depressive symptoms, type-D personality and cardiac symptoms. At one-year follow-up, they completed the Dutch Exertion Fatigue Scale and the Fatigue Assessment Scale to assess symptoms of fatigue. Medical information was obtained from the patients' medical records. Results: Exertion fatigue and general fatigue were identified as different manifestations of fatigue. We found that exertion fatigue at 12-month follow-up was predicted by decreased exercise capacity (β = −.35; p b .001), dyspnoea (β = 24; p = .002), hypertension (β = .16; p = .03), and depressive symptoms (β = .16; p = .05). In contrast, general fatigue at 12-month follow-up was predicted by dyspnoea (β = .24; p = .003), depressive symptoms (β = .27; p b .001), type-D personality (β = 17; p = .03), and sleep problems (β = .20; p = .01). Together, these variables explained 32% and 37% of the variance, respectively. Conclusion: The present study showed that fatigue was related to both clinical and psychological characteristics. The use of this knowledge may lead to a better understanding and treatment of the clinical manifestations of fatigue in CHF.

Background-Depression, anxiety, and type D ("distressed") personality (tendency to experience negative emotions paired with social inhibition) have been associated with poor prognosis in coronary heart disease, but little is known about their role in chronic heart failure. Therefore, we investigated whether these indicators of psychological distress are associated with mortality in chronic heart failure. Method and Results-Consecutive outpatients with chronic heart failure (nϭ641; 74.3% men; mean age, 66.6Ϯ10.0 years) filled out a 4-item questionnaire to assess mixed symptoms of anxiety and depression and the 14-item type D scale. End points were defined as all-cause and cardiac mortality.

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Only somatic/affective depressive symptoms significantly predicted all-cause mortality in CHF. In the context of diagnosing and intervening, awareness of subtypes of depressive symptoms is important.

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