Type D Personality Is Associated With Increased Anxiety and Depressive Symptoms in Patients With an Implantable Cardioverter Defibrillator and Their Partners

Abstract

Partners experienced similar levels of depression but higher levels of anxiety compared with ICD patients. Personality was an important explanatory factor of distress in both ICD patients and their partners. Research is now warranted to investigate the implications of this finding for the clinical course of ICD patients, as Type D personality has been associated with adverse prognosis in patients with coronary artery disease.

Type D personality in Poland: Validity and application of the Polish DS14

“…The prevalence of Type D in Polish healthy subjects was comparable to that found in Danish, German, UK/Irish, and Ukrainian healthy samples, although a lower prevalence (i.e., 13.3%) was found in one study of Dutch healthy controls (Aquarius, Denollet, Hamming, Breek & De Vries, 2005). By contrast, the prevalence of Type D of 72.1% in CVD patients found in the current study was considerably higher than in previous CVD studies conducted in Western Europe (Pedersen, Van Domburg, Theuns, Jordaens & Erdman, 2004;Schiffer, Pedersen, Broers, Widdershoven & Denollet, 2004;Pedersen & Denollet, 2004;Al-Ruzzeh, Athanasiou, Mangoush, Wray, Modine, George, et al, 2005;Denollet, Vaes & Brutsaert, 2000;Grande, Jordan, Kummel, Struwe, Schubmann, Schulze et al, 2004;Whitehead, Perkins-Porras, Strike, Magid & Steptoe, 2007), although a previous study of hypertensives also found an unusually high prevalence, with 53% (Denollet, 2005).…”

“…Type D has been also associated with a broad range of patient-centered outcomes, including increased anxiety (van Gestel, Pedersen, van de Sande, de Jaegere, Serruys, Erdman et al, 2007;Spindler, Pedersen, Serruys, Erdman & van Domburg, 2007;Pedersen, Van Domburg, Theuns, Jordaens & Erdman, 2004;Schiffer, Pedersen, Broers, Widdershoven & Denollet, 2008), post-traumatic stress (Pedersen & Denollet, 2004), depressive symptoms Schiffer, Pedersen, Widdershoven, Hendriks, Winter & Denollet, 2005), vital exhaustion (Pedersen & Middel, 2001;Pedersen, Daemen, van de Sande, Sonnenschein, Serruys, Erdman et al, 2007), poor quality of life (AlRuzzeh, Athanasiou, Mangoush, Wray, Modine, George, et al, 2005;Pedersen, Denollet, Ong, Serruys, Erdman & van Domburg, 2007;, and adverse clinical events (Denollet, Vaes & Brutsaert, 2000;Denollet, Pedersen, Ong, Erdman, Serruys & van Domburg, 2006;Pedersen, Lemos, van Vooren, Liu, Daemen, Erdman et al, 2004).…”

“…The risk of mortality of those diseases associated with Type D is 4-fold, with this risk being independent of disease severity, traditional biomedical risk factors and mood states . Type D personality seems not just to be a phenomenon that is relevant to patients with coronary heart disease, where the construct was initially developed, but also in patients with chronic heart failure (Schiffer, Pedersen, Broers, Widdershoven & Denollet, 2008;Schiffer, Pedersen, Widdershoven, Hendriks, Winter & Denollet, 2005), peripheral arterial disease , and in patients treated with state-of-the-art invasive treatment, including percutaneous coronary intervention with drug-eluting stents (van Gestel, Pedersen, van de Sande, de Jaegere, Serruys, Erdman et al, 2007;Spindler, Pedersen, Serruys, Erdman & van Domburg, 2007;Pedersen, Denollet, Ong, Serruys, Erdman & van Domburg, 2007;Denollet, Pedersen, Ong, Erdman, Serruys & van Domburg, 2006) and device therapy (Pedersen, Van Domburg, Theuns, Jordaens & Erdman, 2004;Pedersen, Theuns, Muskens-Heemskerk, Erdman & Jordaens, 2007). NA and SI were not predictive of outcome individually; only the joint presence of high scores on both dimensions was linked to disease morbidity and mortality (Habra, Linden, Anderson, Weinberg, 2003).…”

Impaired health status in Type D patients following PCI in the drug-eluting stent era

“…Type D has also been associated with more than a 4-fold increased risk of vital exhaustion in patients both preand post-intervention with CABG, PCI or pharmacotherapy [19]. In a recent study of patients with an implantable cardioverter defibrillator, patients and partners with a Type D personality experienced significantly increased levels of distress with the risk ranging from 4-8-fold after adjusting for other factors, including shocks in patients [29]. Taken together, these results indicate that Type D patients comprise a subgroup of patients that may not benefit from pharmacological and invasive treatment on par with non-Type D patients.…”

Type D Patients Report Poorer Health Status Prior to and After Cardiac Rehabilitation Compared to Non-Type D Patients

“…Preliminary evidence indicates that hostile patients may experience more benefits from cardiac rehabilitation in terms of reductions in anxiety and improvement in quality of life [10]. Type D personality is an emerging risk factor in cardiovascular disease that has been shown to predict adverse health outcomes in CAD [11,12], peripheral arterial disease [13], chronic heart failure [14], patients with life-threatening arrhythmias [15], and patients treated with revascularization procedures [16]. Type D is defined by the two normal and stable personality traits Negative Affectivity [17] and Social Inhibition [18].…”