Is type-D a stable construct? An examination of type-D personality in patients before and after cardiac surgery

Dannemann, Stephanie; Matschke, Klaus; Einsle, Franziska; Smucker, Mervin R.; Zimmermann, Katrin; Joraschky, Peter; Weidner, Kerstin; Köllner, Volker

doi:10.1016/j.jpsychores.2010.02.008

« Previous Next »Journal of Psychosomatic Research
Volume 69, Issue 2 , Pages 101-109, August 2010

Is type-D a stable construct? An examination of type-D personality in patients before and after cardiac surgery

Stephanie Dannemann
- Department of Psychosomatics and Psychotherapy, Medical Clinic, University Hospital Carl Gustav Carus, Dresden, Germany
Klaus Matschke
- Department of Cardiac Surgery, Medical Clinic, University Hospital Carl Gustav Carus, Dresden, Germany
Franziska Einsle
- Department of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
Mervin R. Smucker
- Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI, USA
Katrin Zimmermann
- Department of Psychosomatics and Psychotherapy, Medical Clinic, University Hospital Carl Gustav Carus, Dresden, Germany
Peter Joraschky
- Department of Psychosomatics and Psychotherapy, Medical Clinic, University Hospital Carl Gustav Carus, Dresden, Germany
Kerstin Weidner
- Department of Psychosomatics and Psychotherapy, Medical Clinic, University Hospital Carl Gustav Carus, Dresden, Germany
Volker Köllner
- Department of Psychosomatic Medicine, Mediclin, Bliestal Clinic, Blieskastel, Germany
- Faculty of Medicine, Saarland University, Homburg/Saar, Germany
- Corresponding author. Department of Psychosomatic Medicine, Mediclin Bliestal Clinic, Am Spitzenberg, D-66440 Blieskastel, Germany. Tel.: +49 6842542257; fax: +49 6842542340.

Received 1 May 2009; received in revised form 16 February 2010; accepted 18 February 2010. published online 12 April 2010.

Abstract

Objective

Type-D personality—negative affectivity and social inhibition—are related to poor prognosis in cardiovascular diseases. At present, little is known about type-D personality and its stability before and after cardiac surgery.

Methods

One hundred twenty-six patients recommended for coronary bypass and/or valve surgery were examined at pre-surgery and 6 months post-surgery to investigate the stability of type-D (14-item Type-D Scale) and its relationship to anxiety, depression (Hospital Anxiety and Depression Scale) and quality of life (Short Form 12).

Results

Preoperatively, 26% were assessed to have type-D, while only 11% fulfilled type-D criteria both pre- and post-surgery. Patients were assessed and identified as belonging to one of the four type-D groups: Stable type-D (11%), non-type-D (61%), type-D pre (15%), and type-D post (13%). In comparison to the stable non-type D group, the stable type-D reported more symptoms of anxiety, depression, lower physical quality of life post-surgery, and lower mental quality of life both pre- and post-surgery. When compared to the population at large, stable type-D had more symptoms of depression pre-surgery, and more anxiety as well as lower physical and mental quality of life pre- and post-surgery.

Conclusion

Type-D diagnosis changed in nearly 60% of the cases post-surgery. Only those patients with stable type-D exhibited a relationship to emotional distress, such as anxiety and depression and reduced quality of life. Additional research on the critical cut-off scores and stability of type-D as it relates to critical life events would likely enhance our ability to more effectively diagnose and treat patients who are at high risk for insufficient coping.

Keywords: Anxiety, Cardiac surgery, Depression, Distress personality, Quality of life, Type-D personality