Is the concept of type D personality a component of personalized medicine or a prognostic factor in the treatment of cardiovascular diseases?

Сумин, А. Н.; Щеглова, А. В.

doi:10.15829/1560-4071-2020-3996

Cited by 7 publications

(4 citation statements)

References 73 publications

(92 reference statements)

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“…Тип Д -это "уязвимый психотип" для возникновения сердечно-сосудистых заболеваний и усугу-бляю щий фактор, негативно влияющий на исходы после ИМ [4,6,7], что, однако, подтверждается не всеми исследованиями [8]. Распространенность дистрессорного типа у пациентов с ишемической болезнью сердца -~33,5% [9], что согласуется с данным исследованием, где тип Д в общей группе больных с ИМ -составил 30,6%, однако мало данных о распространенности типа Д в зависимости от типа ИМ. Наше исследование демонстрирует распространенность дистрессорного типа в группе ИМ1 -28,3%, а в группе ИМ2 -36,1%.…”

Section: Discussionunclassified

The role of psycho-emotional factors in assessing the prognosis of different types of myocardial infarction

Kinash,

Kashtalap,

Vorobiev

et al. 2023

Russ J Cardiol

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Aim. To study the features of psycho-emotional status and its clinical and prognostic significance in patients with type 1 and 2 myocardial infarction (MI).Material and methods. Of the 1293 patients hospitalized at the District Cardiology Dispensary "Center for Diagnostics and Cardiovascular Surgery" with a diagnosis of acute coronary syndrome, 277 (21,4%) patients with confirmed MI were consecutively included in the observational study. There were 194 (15,0%) patients with type 1 MI (MI1) and 83 (6,4%) with type 2 MI (MI2). MI types were determined based on the IV Universal Definition of Myocardial Infarction (UDMI). During the hospital period, type D personality was identified using the Russian version of the Type D scale-14 (DS-14), while the presence and severity of anxiety and depression was assessed using the Hospital Anxiety and Depression Scale (HADS). Follow-up was conducted through outpatient visits, telephone or email interviews for 12 months after discharge. Patients' adherence to drug therapy was assessed using 8-item Morisky Medication Adherence Scale, and quality of life (QoL) using Short Form Medical Outcomes Study (SF-36) questionnaire.Results. During the hospital period, in the group of patients with MI2, patients with type D personality were more often identified compared with MI1 (30 (36,1%) vs 55 (28,3%), p<0,05). Patients with MI2 had a significantly higher subclinical level of anxiety (34 (41,0%) vs 43 (22,2%), p=0,002), expressed level of anxiety (10 (12,1%) vs 12 (6,2%), p=0,011), as well as a significant level of depression (13 (15,7%) vs 14 (7,2%), p=0,03). At the same time, in patients with type D, regardless of MI type, subclinical levels of anxiety and depression were significantly expressed (63 (74,1%) vs 14 (7,3%) (p<0,001) and 58 (68,2%) vs 25 (13,0%) (p<0,001)). There were no significant differences in inhospital complications between the MI1 and MI2 groups depending on type D personality. After 12-month follow-up, patients with the distressed personality type had higher rate of all-cause death (5 (7,2%) vs 5 (1,6%), p<0,05 without type D), rehospitalization for decompensated heart failure (8 (11,5%) vs 9 (4,8%), p=0,04). Patients with type D were less adherent to drug therapy compared to patients without type D (30 (43,4%) vs 9 (4,8%) p=0,001, respectively), and they had lower QoL scores.Conclusion. Type D personality, the presence of anxiety and depression, high all-cause mortality and rehospitalization rate of decompensated heart failure were more often observed in MI2 compared to MI1, as well as in patients with type D, regardless of MI type. Low adherence to drug therapy and poor quality of life, regardless of MI type, were also associated with the type D personality.

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Section: Discussionunclassified

The role of psycho-emotional factors in assessing the prognosis of different types of myocardial infarction

Kinash,

Kashtalap,

Vorobiev

et al. 2023

Russ J Cardiol

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“…Additional analysis showed the heterogeneity of the type D influenced the prognosis depending on the stage of the disease development (CAD or CHF), age, and used endpoints [6]. In addition, ethnic, geographic and socioeconomic factors, along with cross-cultural differences [7], could also affect the predictive value of type D personality, as shown by a number of studies in Asian countries and Russia, the data on which were summarized in a recent review [8]. At present, the following question seems to be the most urgent: is it possible to influence patients with type D personality to improve the prognosis?…”

Section: Introductionmentioning

confidence: 99%

“…As a result, there is a need to search for other strategies that could improve their prognosis in the treatment of patients with type D personality. In this regard, the use of stress-limiting interventions, as well as impacting the inadequate coping strategies, look promising [8]. Since coping strategies are a stabilizing factor, due to which the psychosocial adaptation of an individual is maintained during the period of exposure to stress, and they can be considered as a potential target for behavioral interventions [11].…”

Section: Introductionmentioning

confidence: 99%

Coping Strategies In Young Healthy Individuals With Type D Personality

2022

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Objective — To study the choice of coping strategies and coping intensity in healthy individuals with type D personality. Material and methods — The study included 98 students of Kemerovo State Medical University (KemSMU), 68 women and 30 men (their mean age was 19.1±2.0 years). All subjects filled out psychological questionnaires to identify type D personality (DS-14) and the choice of coping strategies (Ways of Coping Questionnaire (WCQ) and Coping Strategy Indicator (CSI)). Results — The participants were divided into a group with type D personality (n=44) and without it (n=54). Individuals with type D personality had higher scores on the Escape-Avoidance (p<0.001), Accepting Responsibility (p=0.009) and Distancing (p=0.05) scales of the WSQ questionnaire, and Avoidance strategy scale of the CSI questionnaire (p=0.007). Students with type D personality were characterized by a pronounced preference for the Escape-Avoidance strategy (p=0.000018). An increase of 1 point in the values on the Escape-Avoidance scale improved the chance of identifying type D personality by 1.15 times (p<0.001). An increase in scores on the Positive Reappraisal scale reduced the likelihood of identifying type D personality (OR 0.98; p=0.005). The Escape-Avoidance coping strategy was rather strongly associated with type D personality (AUC=0.779). Conclusion — In healthy young people with type D personality, inadequate coping strategies were notably prevalent: the Escape-Avoidance strategy identified by WCQ, and the Avoidance strategy marked by the CSI. The Escape-Avoidance strategy was independently associated with type D personality, and the Positive Reappraisal strategy was associated with the non-D type.

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“…One of the tasks in the treatment of CAD patients with personality type D is the modification of the patients' reactions to the stressful effects of everyday life [23]. Therefore, it is of interest to study the possible pathogenetic significance of their cognitive assessments of stress and strategies for coping with stress.…”

Section: Introductionmentioning

confidence: 99%

Pathogenetic Mechanisms Underlying Major Adverse Cardiac Events in Personality Type D Patients after Percutaneous Coronary Intervention: The Roles of Cognitive Appraisal and Coping Strategies

Sumin,

Shcheglova

2023

Diagnostics

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Background: This paper aimed to study the association of type D personality, coping strategies, and cognitive appraisal with annual prognosis after a percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD). Methods: The prospective study included 111 CAD patients who underwent a PCI. All participants, before the PCI, completed questionnaires designed to collect information about type D personality, cognitive appraisal, and coping styles. Information was also collected on the clinical and demographic characteristics of the patients. After 1 year of follow-up, the presence of major adverse cardiac events (MACEs) was assessed. Results: The presence of a MACE was noted in 38 patients, and the absence of a MACE was noted in 53 patients. In patients with type D personality, higher incidences of MACEs (54.1% versus 33.3%; p = 0.0489) and hospitalization rates (29.7% versus 7.4%; p = 0.004) were revealed. Patients with poor prognoses preferred a moderate use of the confrontation strategy than patients without a MACE (78.4% vs. 50.9%; p = 0.0082). Patients with MACEs had statistically significantly lower indicators of strong emotions (11.92 ± 5.32 versus 14.62 ± 4.83 points; p = 0.005) and future prospects (11.36 ± 3.81 versus 13.21 ± 3.41 points; p = 0.015) than patients without a MACE. In a multiple binary logistic regression model, the following factors had significant associations with MACE development: type D, moderate use of confrontation coping, moderate use of self-control coping, and strong emotions in cognitive appraisal. Conclusion: This study showed that not only personality type D, but also certain coping strategies and cognitive appraisals increase the likelihood of developing a MACE after a PCI. This provides a theoretical basis for understanding the mechanism underlying type D personality and MACEs in patients after a PCI.

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Is the concept of type D personality a component of personalized medicine or a prognostic factor in the treatment of cardiovascular diseases?

Cited by 7 publications

References 73 publications

The role of psycho-emotional factors in assessing the prognosis of different types of myocardial infarction

The role of psycho-emotional factors in assessing the prognosis of different types of myocardial infarction

Coping Strategies In Young Healthy Individuals With Type D Personality

Pathogenetic Mechanisms Underlying Major Adverse Cardiac Events in Personality Type D Patients after Percutaneous Coronary Intervention: The Roles of Cognitive Appraisal and Coping Strategies

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