Increased Anxiety and Depression in Danish Cardiac Patients with a Type D personality: Cross-Validation of the Type D Scale (DS14)

Abstract

Background Type D personality is an emerging risk factor in cardiovascular disease. We examined the psychometric properties of the Danish version of the Type D Scale (DS14) and the impact of Type D on anxiety and depression in cardiac patients. Method Cardiac patients (n=707) completed the DS14, the Hospital Anxiety and Depression Scale, and the Eysenck Personality Questionnaire. A subgroup (n = 318) also completed the DS14 at 3 or 12 weeks. Results The two-factor structure of the DS14 was confirmed; the subscales negative affectivity and social inhibition were shown to be valid, internally consistent (Cronbach's α=0.87/0.91; mean inter-item correlations= 0.49/0.59), and stable over 3 and 12 weeks (r=0.85/0.78; 0.83/0.79; ps<0.01). Type D was an independent associate of anxiety (β, 0.49; p<0.01) and depression (β, 0.47; p< 0.01) in univariable linear regression analysis and remained a significant independent associate of anxiety (β, 0.26; p< 0.01) and depression (β, 0.17; p < 0.01) in adjusted analyses. Conclusions The Danish DS14 was shown to be a valid and reliable measure associated with increased symptoms of anxiety and depression independent of sociodemographic and clinical risk factors. The DS14 may be used in research and clinical practice to identify high-risk patients.

Reliability and Validity of Russian Version of Ds14 Score for Ischemic Heart Disease Patients

“…Результаты предыдущих работ показали положи-тельную корреляцию между NA и SI c уровнями тре-воги, депрессии [16], враждебности [14], что хорошо сочетается с результатами нашего исследования. Обратная корреляционная зависимость была обнару-жена между SI и экстраверсией [5].…”

A General Propensity to Psychological Distress Affects Cardiovascular Outcomes

“…Evidence also shows that after control for depressive symptoms, Type D was associated with ventricular arrhythmia, 52 increased cortisol, 53,54 and oxidative stress 55 in cardiac patients. Further, Type D predicted the onset, 33 prevalence, 36,46,47 persistence, 35,48 and severity 37 of depression and anxiety symptoms in cardiac patients, adjusting for baseline depression scores. In addition, Type D is associated with poor health status and fatigue, 38,[57][58][59][60] adjusting for depressive symptoms.…”

“…42 Factor analysis including the BDI and HADS depression scales confirmed that the items from the 14-item Type D Scale (DS14) 15 were distinctly different from depressive symptoms in cardiac patients. 44 In addition, Type D predicted the onset of depressive symptoms in patients who were free from depression at baseline 33 and predicted the prevalence 46,47 and persistence 48 of depressive symptoms, adjusting for baseline levels of depression.…”

Type D Personality as a Cardiovascular Risk Marker in the General Population: Results from the Gutenberg Health Study

“…Regarding health behavior, Spindler et al [23] found no associations of type D with smoking or cardiovascular risk factors in cardiac patients, but in a community sample [4], a slightly reduced rate of healthy diet and physical activity was reported. Regarding health care utilization, inadequate consultation behavior has been reported for them [24,25].…”