Type D personality is a predictor of poor emotional quality of life in primary care heart failure patients independent of depressive symptoms and New York Heart Association functional class

J Behav Med. 2010 Feb;33(1):72-80. doi: 10.1007/s10865-009-9236-1.

Abstract

Quality of life is an important patient-centered outcome and predictor of mortality in heart failure, but little is known about the role of personality as a determinant of quality of life in this patient group. We examined the influence of Type D personality (i.e., increased negative emotions paired with emotional non-expression) on quality of life in primary care heart failure patients, using a prospective study design. Heart failure patients (n = 251) recruited from 44 primary care practices in Germany completed standardized questionnaires at baseline and 9 months. The prevalence of Type D was 31.9%. Type D patients experienced poorer emotional (P < .001) and physical quality of life (P = .01) at baseline and 9 months compared to non-Type D patients. There was no significant change in emotional (P = .78) nor physical quality of life (P = .74) over time; neither the interaction for time by Type D for emotional (P = .31) nor physical quality of life (P = .91) was significant, indicating that Type D exerted a stable effect on quality of life over time. Adjusting for demographics, New York Heart Association functional class, and depressive symptoms, Type D remained an independent determinant of emotional (P = .03) but not physical quality of life (P = .29). Primary care heart failure patients with a Type D personality experienced poorer emotional but not physical quality of life compared to non-Type D patients. Patients with this personality profile should be identified in primary care to see if their treatment is optimal, as both Type D and poor quality of life have been associated with increased morbidity and mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Depression / epidemiology
  • Depression / psychology*
  • Emotions*
  • Female
  • Follow-Up Studies
  • Germany
  • Heart Failure / epidemiology
  • Heart Failure / psychology*
  • Humans
  • Male
  • Personality Tests
  • Personality*
  • Prevalence
  • Primary Health Care
  • Prognosis
  • Prospective Studies
  • Quality of Life / psychology*
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome