Document Detail

Type D personality predicts clinical events after myocardial infarction, above and beyond disease severity and depression.
MedLine Citation:
PMID:  20156412     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the effect of Type D personality (high negative affectivity and social inhibition) on cardiac death and/or recurrent myocardial infarction (MI) in patients with acute MI, after adjustment for disease severity and depression. To explore the differential effect of Type D on early (< or = 6 months) versus late (> 6 months) events separately. METHOD: Patients hospitalized for acute MI (N = 473) were recruited between May 2003 and May 2006. Patients were assessed on demographic and clinical variables and completed the Type D Personality Scale within the first week of hospital admission for acute MI; depression severity was assessed with the 17-item Hamilton Depression Rating Scale. The mean follow-up period was 1.8 years. RESULTS: There were 44 events attributable to cardiac death (n = 16) or recurrent MI (n = 28), with 26 early and 18 late events. Type D patients were at cumulative increased risk of death/recurrent MI compared with non-Type D patients (16.3% vs 7.8%; P = .012). Cardiac history, left ventricular ejection fraction, and use of statins were predictors of total and late death/recurrent MI, with statins showing a substantial protective effect. In addition, cardiac history and use of statins were significantly associated with early death/recurrent MI. Type D patients had a 2-fold increased risk of total death/recurrent MI after adjustment for disease severity and depression (HR = 2.23; 95% CI, 1.14-4.35; P = .019) and a more than 3-fold increased risk of late death/recurrent MI (HR = 3.57; 95% CI, 1.23-10.30; P = .019). CONCLUSIONS: Type D was a strong predictor of adverse cardiac outcome after acute MI, above and beyond disease severity and depression severity, and the associated risk was similar to that of traditional cardiovascular risk factors. Type D may be an important psychosocial factor to assess in patients post-MI for risk stratification purposes.
Elisabeth J Martens; Floortje Mols; Matthew M Burg; Johan Denollet
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-09
Journal Detail:
Title:  The Journal of clinical psychiatry     Volume:  71     ISSN:  1555-2101     ISO Abbreviation:  J Clin Psychiatry     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-24     Completed Date:  2010-07-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7801243     Medline TA:  J Clin Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  778-83     Citation Subset:  IM    
Copyright Information:
2010 Physicians Postgraduate Press, Inc.
CoRPS Center of Research on Psychology in Somatic diseases, Department of Medical Psychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE Tilburg, The Netherlands.
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MeSH Terms
Cause of Death
Depressive Disorder / diagnosis*,  epidemiology
Disease Progression
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Middle Aged
Myocardial Infarction / diagnosis*,  epidemiology,  mortality
Outcome Assessment (Health Care) / statistics & numerical data
Personality / classification*
Personality Inventory / statistics & numerical data
Proportional Hazards Models
Regression Analysis
Risk Factors
Severity of Illness Index
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

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