Type D personality is a predictor of poor emotional quality of life in primary care heart failure patients independent of depressive symptoms and New York Heart Association functional class

Abstract

Quality of life is an important patient-centered outcome and predictor of mortality in heart failure, but little is known about the role of personality as a determinant of quality of life in this patient group. We examined the influence of Type D personality (i.e., increased negative emotions paired with emotional non-expression) on quality of life in primary care heart failure patients, using a prospective study design. Heart failure patients (n = 251) recruited from 44 primary care practices in Germany completed standardized questionnaires at baseline and 9 months. The prevalence of Type D was 31.9%. Type D patients experienced poorer emotional (P < .001) and physical quality of life (P = .01) at baseline and 9 months compared to non-Type D patients. There was no significant change in emotional (P = .78) nor physical quality of life (P = .74) over time; neither the interaction for time by Type D for emotional (P = .31) nor physical quality of life (P = .91) was significant, indicating that Type D exerted a stable effect on quality of life over time. Adjusting for demographics, New York Heart Association functional class, and depressive symptoms, Type D remained an independent determinant of emotional (P = .03) but not physical quality of life (P = .29). Primary care heart failure patients with a Type D personality experienced poorer emotional but not physical quality of life compared to non-Type D patients. Patients with this personality profile should be identified in primary care to see if their treatment is optimal, as both Type D and poor quality of life have been associated with increased morbidity and mortality.

Does type-D personality predict outcomes among patients with cardiovascular disease? A meta-analytic review

“…Impaired HRQOL has also been observed both in Type-D coronary artery bypass grafting surgery patients [24] and in a sample of Type-D coronary artery disease patients both pre-and post-cardiacrehabilitation as compared to non-Type-D patients [25]. Impaired emotional HRQOL is also associated with Type-D personality in primary care heart failure patients [26] Biochemical markers Biological indicators of prognosis in cardiovascular disease include proinflammatory cytokines. Two important proinflammatory cytokines are tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6).…”

“…Relevant titles were identified, and their abstracts were reviewed for possible inclusion. One additional study [26] was serendipitously identified as a result of editorial work by K.S.M. During the review process, two additional studies that reviewers suggested and that met inclusion criteria were added [40,41].…”

Type D personality and three-month psychosocial outcomes among patients post-myocardial infarction

“…A large body of evidence has suggested a link between Type D and subjective health (including impaired physical health, increased symptoms of depression and anxiety, and lower quality of life) in CHF patients and those with peripheral arterial disease (PAD) [18][19][20][21][22]. Studies have also demonstrated the usefulness of the Type D construct in predicting subjective outcomes in post-MI patients.…”

Psychosomatik der Herzinsuffizienz

“…B. Angst oder bestimmte Persönlichkeitszüge [27]. Auch die bei herzinsuffizienten Patienten häufigen sexuellen Funktionsstörun-gen können zur psychischen Belastung und zur Einschränkung der Lebensqualität führen [28].…”