Is type-D a stable construct? An examination of type-D personality in patients before and after cardiac surgery

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• 作者：Stephanie Dannemann ; Klaus Matschke ; Franziska Einsle ; Mervin R. Smucker ; Katrin Zimmermann ; Peter Joraschky ; Kerstin Weidner ; Volker Kö ; llner
• 关键词：Anxiety ; Cardiac surgery ; Depression ; Distress personality ; Quality of life ; Type-D personality
• 刊名：Journal of Psychosomatic Research
• 出版年：2010
• 出版时间：August 2010
• 年：2010
• 卷：69
• 期：2
• 页码：101-109
• 全文大小：162 K

文摘

Objective

Type-D personality—negative affectivity and social inhibition—are related to poor prognosis in cardiovascular diseases. At present, little is known about type-D personality and its stability before and after cardiac surgery.

Methods

One hundred twenty-six patients recommended for coronary bypass and/or valve surgery were examined at pre-surgery and 6 months post-surgery to investigate the stability of type-D (14-item Type-D Scale) and its relationship to anxiety, depression (Hospital Anxiety and Depression Scale) and quality of life (Short Form 12).

Results

Preoperatively, 26 % were assessed to have type-D, while only 11 % fulfilled type-D criteria both pre- and post-surgery. Patients were assessed and identified as belonging to one of the four type-D groups: Stable type-D (11 % ), non-type-D (61 % ), type-D pre (15 % ), and type-D post (13 % ). In comparison to the stable non-type D group, the stable type-D reported more symptoms of anxiety, depression, lower physical quality of life post-surgery, and lower mental quality of life both pre- and post-surgery. When compared to the population at large, stable type-D had more symptoms of depression pre-surgery, and more anxiety as well as lower physical and mental quality of life pre- and post-surgery.

Conclusion

Type-D diagnosis changed in nearly 60 % of the cases post-surgery. Only those patients with stable type-D exhibited a relationship to emotional distress, such as anxiety and depression and reduced quality of life. Additional research on the critical cut-off scores and stability of type-D as it relates to critical life events would likely enhance our ability to more effectively diagnose and treat patients who are at high risk for insufficient coping.