Clinical and psychological associations and coping strategies for personality type D and depression in patients with coronary artery disease

Abstract

The comorbidity of manifestations of psychological distress and cardiovascular diseases is complex. The degree of impact of psychological stress on the patient depends on the possibilities of the adaptive potential of the individual in the environment.Aim: To study the cognitive assessment of stress, coping strategies and clinical and psychological associations in personality type D and depression in patients with coronary artery disease (CAD).Material and Methods. The study included 112 CAD patients. The DS-14 questionnaire was used to determine personality type D.To determine the level of depression the hospital scale HADS (Hospital Anxiety and Depression Scale). To assess coping strategies, the questionnaires “Methods of Coping Behavior” and “Indicator of Stress Coping Strategies” were used. Difficult life situation (DLS) assessment was determined using the “Cognitive Assessment of DLS” methodology. The questionnaire “Types of Orientations in Difficult Situations” was used to study orientations in DLS.Results. Patients were divided into groups based on manifestations of psychological distress: with type D (n = 40), without type D (n = 72); with depression (n = 48) without depression (n = 82). In type D, there was a more frequent assessment of the situation as out of control (12.0 ± 4.6 points versus 11.0 ± 4.6 points, p = 0.049) and orientation towards losses in difficult situations (17.0 ± 4.1 points 15.5 ± 5.1, points, p = 0.016). In depression, less pronounced desire for difficulties (19.0 ± 5.0 points versus 23.0 ± 5.9 points, p = 0.006), orientation towards opportunities (15.5 ± 3.2 points versus 18.0 ± 3.5 points, p < 0.001). In type D, the strategies “Escape-avoidance” (p = 0.05) and “Self-control” (p = 0.04) were used more often. In depression, the strategies “Problem resolution” (p = 0.02), “Search for social support” (p < 0.001) and “Avoidance” (p = 0.02) were more often used, less often – “Confrontational coping” (p = 0.001).Conclusion. Differences in cognitive assessment and coping strategies were revealed in patients with coronary artery disease in personality type D and the development of depression symptoms. This study emphasizes the need for individualized behavioral interventions for patients with coronary artery disease with manifestations of psychological distress.