The impact of the Type D Personality pattern on prehospital delay in patients suffering from acute myocardial infarction

Abstract

Background: The Type D Personality (TDP) has been specifically linked to acute myocardial infarction (AMI). However, the impact on prehospital delay of AMI patients is unclear. The aim of this study was to assess the relationship between TDP and pre-hospital delay time (PHT) in a Chinese population. Methods: A total of 256 AMI patients (47 women and 209 men) were taken from the Multicenter Delay in Patients Experiencing AMI in Shanghai (MEDEA FAR-EAST) study. Sociodemographic and psychobehavioral characteristics were assessed by bedside interviews and questionnaires. TDP was evaluated according to the Type D Personality Scale (DS14) subdivided in social inhibition (SI) and negative affectivity (NA). Based on a significant interaction analysis of TDP and sex on PHT, all analyses were stratified by sex.Results: PHT of female patients with TDP were substantially shorter compared to non-TDP female patients (108 vs. 281 min, P=0.029). In male patients, no effect of TDT on PHT was found. Spearman correlation analysis suggests that NA was negatively correlated with PHT (r=−0.358, P=0.014). Further age-adjusted logistic regression analyses showed that female patients with TDP were generally less likely to prehospital delay compared with non-TDP patients (OR =0.28; 95% CI, 0.08-0.98) and had a lower risk of PHT >360 minutes (OR =0.10; 95% CI, 0.01-0.91). However, statistical significance disappeared after adjustment for psychological factors (anxiety, depression, suboptimal wellbeing, cardiac denial and stress event). Conclusions: TDP is associated with less prehospital delay in female patients during AMI-an effect which may be particularly mediated by NA.

Job Burnout Is Associated With Prehospital Decision Delay: An Internet-Based Survey in China

“…One recent review concludes that so far there is limited evidence for a relationship between prehospital delay and knowledge of symptoms (Mooney et al, 2012 ). The correlation between type D personality especially for negative affectivity and prehospital decision delay was another finding of this research, although this phenomenon has already been reported before (Zhang et al, 2020 ). In our study, a mediating effect of type D personality in the relationship between job burnout and the prehospital delay was not found, indicating that certain personalities might have exerted a non-negligible effect in the delay independent of job fatigue.…”

Number of comorbidities and the risk of delay in seeking treatment for coronary heart disease: a longitudinal study in Bogor City, Indonesia

“…Another study investigated the role of personality in AMI. It found that women with AMI and a type D personality (TDP) who have a tendency to experience negative emotions and to inhibit the expression of emotions, were generally less likely to delay seeking treatment compared to those without TDP (OR, 0.28; 95% CI, 0.08–0.98) [ 24 ]. However, depression may increase the delay in seeking treatment among participants with CHD [ 25 ].…”

Gender disparities in the mediating role of symptom knowledge level in reducing acute coronary syndrome (ACS) decision delay: Findings from a community-based study in China

“…This outcome suggests that while increasing knowledge might help reduce decision delays for males, alternative strategies may be necessary for females, who may face other gender-specific barriers. For instance, Zhang et al identified Type D personality—a tendency towards negative affectivity and social inhibition—as a possible risk factor for delayed medical help-seeking in ACS among females [ 34 ]. Arrebola-Moreno et al corroborated this, finding that Type D personality was linked to decision delays exclusively in females [ 35 ].…”