Type D personality is associated with impaired health-related quality of life 7 years following heart transplantation

Pedersen, Susanne S.; Holkamp, Pieter G.; Caliskan, Kadir; van Domburg, Ron T.; Erdman, Ruud A.M.; Balk, Aggie H.M.M.

doi:10.1016/j.jpsychores.2006.06.008

« Previous Next »Journal of Psychosomatic Research
Volume 61, Issue 6 , Pages 791-795, December 2006

Type D personality is associated with impaired health-related quality of life 7 years following heart transplantation

Susanne S. Pedersen
- Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands
- Centre of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
- Corresponding author. CoRPS, Department of Medical Psychology, Room P503a, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE Tilburg, The Netherlands. Tel.: +31 13 466 2503; fax: +31 13 466 2370.
Pieter G. Holkamp
- Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands
Kadir Caliskan
- Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands
Ron T. van Domburg
- Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands
Ruud A.M. Erdman
- Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands
- Department of Medical Psychology and Psychotherapy, Erasmus Medical Centre, Rotterdam, The Netherlands
Aggie H.M.M. Balk
- Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands

Received 21 March 2006; received in revised form 25 May 2006; accepted 27 June 2006.

Abstract

Objective

Health-related quality of life (HRQoL) following transplantation is gaining importance as an endpoint, but little is known about the role of normal personality traits as a determinant of HRQoL in this patient group. We investigated whether Type D personality (tendency to experience increased negative emotions paired with the nonexpression of these emotions) was associated with impaired HRQoL in heart transplant recipients.

Methods

Data were collected from all surviving heart transplant recipients ≥21 years of age (n=186) with a mean (S.D.) of 7 (5) years following transplantation. Patients completed the Short-Form Health Survey 36 (SF-36) and the Type D Scale (DS14). Clinical data were obtained from the medical records.

Results

Of the 186 patients, 18% had a Type D personality. Type D patients had significantly worse scores on the Physical Component scale (PCS) (P=.04) and the Mental Component scale (MCS) (P<.001) of the SF-36 and all the SF-36 subdomains (all P<.01) compared with non-Type D patients, except for Bodily Pain. Type D personality remained an independent determinant of impaired PCS [odds ratio (OR), 3.62; 95% confidence interval (CI), 1.25–10.45] and MCS (OR, 6.13; 95% CI, 2.23–16.83) and six of the eight subscales of the SF-36, adjusting for demographic and clinical characteristics.

Conclusions

Type D personality was associated with more than a three- to six-fold increased risk of impaired HRQoL in heart transplant recipients, showing that the Type D personality construct also has value in heart transplant recipients. The adoption of a personality approach may lead to improved risk stratification in research and clinical practice in this patient group.

Keywords: Health-related quality of life, Heart transplantation, Type D personality