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. 2015 Sep;79(3):214-21.
doi: 10.1016/j.jpsychores.2015.05.014. Epub 2015 Jun 6.

Prognostic value of type D personality for 10-year mortality and subjective health status in patients treated with percutaneous coronary intervention

K Dulfer  1 , B A F Hazemeijer  2 , M R Van Dijk  2 , R J M Van Geuns  2 , J Daemen  2 , R T Van Domburg  3 , E M W J Utens  1
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Prognostic value of type D personality for 10-year mortality and subjective health status in patients treated with percutaneous coronary intervention

K Dulfer et al. J Psychosom Res. 2015 Sep.

Abstract

Objective: Given the debate around limitations and controversies in type D personality studies, we aimed to evaluate the prognostic value of 'synergistically' analyzed type D personality (interaction z-scores negative affectivity NA, and social inhibition SI) on 10-year mortality and on 10-year subjective health status in percutaneous coronary intervention (PCI) patients.

Methods: This prospective study comprised a cohort of 1190 consecutive patients who underwent PCI between October 2001 and September 2002 (73% male, mean age: 62years, range [27-90]years). At baseline, type D personality (DS14), and depression/anxiety (HADS) were assessed. Primary endpoint was 10year all-cause mortality; secondary endpoint was 10-year subjective health status (SF-36).

Results: After a median follow-up of 10.3years (IQR 9.8-10.8), 293 deaths of any cause (24.6%) were recorded. After adjustment for significant baseline characteristics, personality categories approached and dichotomously approached type D personality were associated with 10-year mortality, p<.05. Synergistically approached type D personality was not associated with all-cause mortality or subjective health status at 10years. In survivors, higher NA was associated with lower subjective health status. Type D was not associated with mortality after adjusting for continuous depression and anxiety in all approaches.

Conclusions: Synergistically analyzed type D was not associated with 10-year all-cause mortality in PCI patients whereas dichotomous type D was. However, after adjustment for depression most of the findings had disappeared. Depression played an important role in this. Type D was not associated with 10-year subjective health status.

Keywords: Depression; Mortality; Percutaneous coronary intervention; Subjective health status; Type D personality.

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