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Gepubliceerd in: Netherlands Heart Journal 4/2017

Open Access 24-01-2017 | Letter to the Editor

Type D personality as a predictor of poor health outcomes in patients with cardiovascular disease

Auteurs: E. M. Pluijmers, J. Denollet

Gepubliceerd in: Netherlands Heart Journal | Uitgave 4/2017

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ZOEKEN
To the Editor,
With great interest we have read the study by Al-Qezweny et al. [1]. In this prospective study the association between Type D personality and depression was investigated in patients who have been treated with percutaneous coronary intervention (PCI). The researchers found an increased risk for depression and anxiety in PCI patients with a Type D personality compared with PCI patients with a non-Type D personality.
This interesting study sheds more light on the complex relationship between depression and Type D personality. Type D personality is a multifaceted construct which consists of two components: negative affectivity and social inhibition [2]. Negative affectivity is composed of three facets: dysphoria, anxious apprehension, and irritability [2]. In other words, dysphoria is one of the constituting facets of negative affectivity, and the association between Type D personality and depression also validates the negative affectivity component of Type D. This partial overlap was found in several studies which, however, also supported the psychometric distinctiveness of the Type D personality as compared with depression [2, 3]. Overall, research indicates that Type D personality is a predictor or vulnerability factor of depression [3], which is also supported by the findings reported by Al-Qezweny et al.
As stressed above, Type D personality not only focuses on negative affectivity but also on social inhibition. To explore the relationship between social inhibition and depression, previous research examined four personality groups based on high and low scores of social inhibition and negative affectivity in relation to depression [3]. Depressive disorder and depressive symptoms were more prevalent in the Type D group characterised by high scores for both negative affectivity and social inhibition, as compared with patients who scored high on negative affectivity but low on social inhibition. Hence, the combination of social inhibition and negative affectivity within the Type D personality construct further increased the risk of depression, above and beyond the main effect of the negative affectivity component by itself [3].
Other empirical evidence showed that Type D personality was also an independent predictor of major adverse cardiac events in patients with coronary artery disease, even after adjustment for depression [2]. This association could be explained by dysregulations of the neuroendocrine, autonomic nervous, and immune systems as was found in several studies. For example, Type D personality has been associated with heightened levels of disease-promoting biomarkers (e. g. oxidative stress and macrophage activity) while controlling for depression [2, 3]. This indicates Type D and depression are only partly overlapping constructs, that may independently predict cardiac events.
The results of the study of Al-Qezweny et al. [1] provide important new evidence for the potential value of Type D personality as a predictor of poor health outcomes in patients with cardiovascular disease.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

Literatuur
1.
go back to reference Al-Qezweny MN, Utens EM, Dulfer K, et al. The association between Type D personality, and depression and anxiety ten years after PCI. Neth Heart J. 2016;24:538–43.CrossRefPubMedPubMedCentral Al-Qezweny MN, Utens EM, Dulfer K, et al. The association between Type D personality, and depression and anxiety ten years after PCI. Neth Heart J. 2016;24:538–43.CrossRefPubMedPubMedCentral
2.
go back to reference Denollet J, Pedersen SS, Vrints CJ, Conraads VM. Predictive value of social inhibition and negative affectivity for cardiovascular events and mortality in patients with coronary artery disease: the Type D personality construct. Psychosom Med. 2013;75:873–81.CrossRefPubMed Denollet J, Pedersen SS, Vrints CJ, Conraads VM. Predictive value of social inhibition and negative affectivity for cardiovascular events and mortality in patients with coronary artery disease: the Type D personality construct. Psychosom Med. 2013;75:873–81.CrossRefPubMed
3.
go back to reference van Dooren FE, Verhey FR, Pouwer F, et al. Association of Type D personality with increased vulnerability to depression: Is there a role for inflammation or endothelial dysfunction? – The Maastricht Study. J Affect Disord. 2016;189:118–25.CrossRefPubMed van Dooren FE, Verhey FR, Pouwer F, et al. Association of Type D personality with increased vulnerability to depression: Is there a role for inflammation or endothelial dysfunction? – The Maastricht Study. J Affect Disord. 2016;189:118–25.CrossRefPubMed
Metagegevens
Titel
Type D personality as a predictor of poor health outcomes in patients with cardiovascular disease
Auteurs
E. M. Pluijmers
J. Denollet
Publicatiedatum
24-01-2017
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 4/2017
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-017-0949-4

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Letter to the Editor

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