Association of Psychiatric History and Type D Personality with Symptoms of Anxiety, Depression, and Health Status Prior to ICD Implantation

Abstract

BackgroundPersonality factors and psychiatric history may help explain individual differences in risk of psychological morbidity and poor health outcomes in patients with an implantable cardioverter defibrillator (ICD).PurposeWe examined associations between previous anxiety and depressive disorder, type D personality, anxiety or depressive symptoms, and health status in ICD patients prior to ICD implantation.MethodPatients (N = 278; 83 % men; mean age = 62.2 years ±11) receiving a first ICD from September 2007 through April 2010 at the Medisch Spectrum Twente, The Netherlands completed validated questionnaires before implantation assessing type D personality (14-item Type D Scale), anxiety and depressive symptoms (Hospital Anxiety and Depression Scale), and health status (36-item Short Form Health Survey). History of anxiety or depressive disorder was assessed with the Mini International Neuropsychiatric Interview structural interview.ResultsPrevious anxiety or depressive disorder was prevalent in 8 and 19 % of patients, respectively. Type D personality was present in 21 %, depressive symptoms in 15 %, and anxiety in 24 %. In adjusted analyses, type D personality was a dominant correlate of previous depressive disorder (odds ratio (OR) 6.2, p < 0.001) and previous anxiety disorder (OR 3.9, p = 0.004). Type D personality (OR 4.0, p < 0.001), age (OR 1.03, p = 0.043), and gender (OR 2.5, p = 0.013) were associated with anxiety symptoms at baseline. Type D personality (OR 5.9. p < 0.001) was also associated with increased depressive symptoms at baseline. Heart failure and type D personality were related to poorer health status.ConclusionIn ICD patients, prior to ICD implantation, a previous anxiety or depressive disorder, type D personality, and anxiety and depressive symptoms were associated with poorer health status. Type D personality was also independently associated with increased anxiety and depression symptoms.

Post-traumatic stress disorder, emotional processing and Inappropriate Implantable Cardioverter-Defibrillator Shocks: clinical consideration by a single case report

“…Studies on the prognostic value of personality in patients with ICD have highlighted the significant role of personality type D. Studies show the prognostic importance of Type-D personality on ICD mortality [16,17], poorer health status [18][19][20][39][40][41], psychiatric symptoms [21,22] and ventricular arrhythmia [23]. These results lead to the hypothesis as the Type-D personality has an important role in fostering inappropriate shocks.…”

Best practice in psychological activities in cardiovascular prevention and rehabilitation: Position Paper

“…Patients with type D personality are more likely to develop depression or anxiety disorder pre-implant because they are more exposed to psychological distress, morbidity and mortality [254,255]. Patients with a younger age, increased depression score at baseline, and Type D personality were especially prone to experience PTSD and anxiety symptomatology at 12 months follow-up [244].…”

Osobowość typu D i choroba sercowo-naczyniowa: przegląd literatury

“…It seems that it is associated with increased morbidity [37], poor quality of life [37], poor prognosis and mortality [38] in patients with cardiovascular diseases [28,39,40]. In addition, people with type D personality have poor general health and a lot of health-threatening situations [41][42][43]. In general, type D personality ranges from 13% to 25% in general population, whereas in patients with cardiovascular disorders it reaches 26% to 53% [29,44,45].…”