Type D Personality Predicts Poor Medication Adherence in Chinese Patients with Type 2 Diabetes Mellitus: A Six-Month Follow-Up Study

A particularly high mortality risk was observed in the presence of prior depression for most somatic diseases. Future studies that assess the underlying mechanisms are necessary to adequately address the excessive mortality associated with comorbid depression.

ObjectiveThe aim of this study was to estimate the prevalence of Type D personality and assess the relationship between this personality type and self-efficacy/social support in Chinese patients with type 2 diabetes mellitus (T2DM).Patients and methodsFrom January 1, 2014, to July 31, 2014, 532 consecutive patients with T2DM were recruited from two hospitals in Guangzhou, China. The participants completed questionnaires containing questions about sociodemographic characteristics, Type D personality, self-efficacy, and social support scales, and their medical records were reviewed for additional data.ResultsOf the 532 patients, 18.2% had Type D personality. Patients with this personality type reported significantly lower levels of self-efficacy (P<0.001), total social support (P<0.001), subjective support (P<0.001), and support utilization (P=0.003), but similar level of objective support (P=0.314), compared to those of patients without Type D personality. Negative affectivity and social inhibition, two intrinsic traits of Type D personality, negatively correlated with self-efficacy and social support scores. Type D personality was significantly associated with less self-efficacy and social support (P<0.001), controlling for other sociodemographic factors. Glycosylated hemoglobin (HbA1c) levels were significantly higher in T2DM patients with Type D personality than in patients with non-Type D personality.ConclusionThis study provides new evidence linking Type D personality with self-efficacy, social support, and poor glycemic control, highlighting the special need for care among T2DM patients with Type D personality.

Background: Type D personality is a combination of 2 traits which are negative affectivity and social inhibition. In health care situation, type D patients are more likely to have non-medication adherence, pessimistic about their ability to cope with illness and believe that it will be long-lasting which lead them to present worse health outcomes. This study aimed to examine the prevalence of type D personality and associations among medication self-efficacy and self-care behaviors in patients with hypertension. Methods: This is a descriptive cross-sectional study. Patients with hypertension (n = 383) who attended a primary care unit were recruited. Volunteering participants completed the Type D-Scale (DS14) questionnaire for the evaluation of the prevalence of type D personality. To evaluate medication self-efficacy and self-care behavior, Self-efficacy for Appropriate Medication Use Scale Thai version and Self-care behaviors scale for patients with hypertension were employed. Descriptive statistics, t-test, and Pearson’s correlations were used in data analysis. Results: Fifty-six participants (14.6%) were classified with type D personality (26 males and 30 females). A positive relationship between medication self-efficacy and self-care behavior was found (r = 0.294, p < 0.01). In contrast, type D personality had a negative association with medication self-efficacy and self-care behavior (r = -0.251, r = -0.138, p < 0.01). Conclusion: Compare to the previous studies, the present study illustrated quite lower prevalence of type D personality. Type D personality is a psychological health risk factor which negatively affects health both directly and indirectly, especially self-efficacy and self-care behavior. Even just one of the two type D personality traits can lead to a similar detrimental result. Positive relationship between medication self-efficacy and self-care behavior can be applied to develop health promotion programs for patient with hypertension.