Type D Personality as a Cardiovascular Risk Marker in the General Population: Results from the Gutenberg Health Study

Abstract

Background: Type D personality is considered as an independent risk factor for morbidity and mortality in cardiovascular patients and a vulnerability factor for distress in the general population. Because representative community studies are rare, we sought to determine the prevalence of type D personality and its relationship with demographic characteristics, different features of mental disorders, cardiovascular risk factors, health behavior, endothelial function and cardiovascular biomarkers in the general population. Methods: The prevalence of type D personality and its correlates were analyzed cross-sectionally in a population-based sample of 5,000 Mid-Europeans aged 35–74 years from the Gutenberg Health Study. Results: The prevalence of type D personality was 22.2% without remarkable differences in sex distribution. Type D subjects were characterized by lower socioeconomic status, lack of a partnership, increased depression, anxiety, depersonalization and health care utilization. Despite its strong association with mental disorders, type D personality emerged as psychometrically distinct. Although type D personality was independently associated with coronary heart disease (OR = 1.54, p = 0.044), no associations with traditional cardiovascular risk factors were found independently from depression or anxiety. Conclusions: Although type D personality is strongly associated with depression, anxiety, impaired mental and somatic health status, and increased health care utilization, the type D construct seems to comprise dysfunctional personality patterns not covered by depression and anxiety scales. Beyond these associations, the pathways of the cardiotoxic impact of type D personality remain to be elucidated. There is a need for prospective population studies on potential links between type D personality and cardiac disease.

The impact of type d personality on health-related quality of life in patients with symptomatic haemorrhoids

“…Type D personality was found in around one-sixth of the general population [24, 25], and the prevalence of type D personality in cardiac patients varied widely from 5.3% [26] to 53% [3]. In the present study, a similar prevalence (29.2%) of type D personality was found among patients with haemorrhoids.…”

Association of Type D personality with increased vulnerability to depression: Is there a role for inflammation or endothelial dysfunction? – The Maastricht Study

“…One study reported a reduction of 54% of endothelial progenitor cells in Type D compared with non-Type D persons (Van Craenenbroeck et al, 2009), however, another study reported no association of Type D with endothelial dysfunction (Beutel et al, 2012). To our knowledge, we are the first to examine the association of Type D with endothelial function in a large population-based study, assessing a wide variety of biomarkers, and showing a significant association.…”

Is Depression the Wrong Treatment Target for Improving Outcome in Coronary Artery Disease?

“…In the same vein, it is likely that psychotherapy protocols focusing on depressive symptoms in cardiac settings may overlook other important negative affective components associated with depression, such as anxiety, anger, hostility, distress or a general disposition toward negative affectivity and personality traits [43,45,46,47,48,49,50,51,52]. These components that are associated with depression, if untreated, could interfere with medical outcomes due to a combination of the effects on inflammation, catecholamines, heart-rate variability and endothelial function, along with effects on health-promoting behaviors [53].…”