Schiffer Angélique A, Pedersen Susanne S, Widdershoven Jos W, Hendriks Eric H, Winter Jobst B, Denollet Johan
Department of Psychology and Health, Tilburg University, The Netherlands.
Eur J Cardiovasc Prev Rehabil. 2005 Aug;12(4):341-6. doi: 10.1097/01.hjr.0000173107.76109.6c.
Chronic heart failure (CHF) is a serious condition that is associated with impaired health status and a high prevalence of depressive symptoms. To date, little is known about the determinants of health status and depressive symptoms in CHF. Therefore, the aim of this study was to assess whether Type D personality is associated with impaired health status and increased depressive symptoms in heart failure patients, independent of disease characteristics.
Eighty-four patients (63 men and 21 women, mean age=65.9+/-12.1 years) with systolic CHF completed four questionnaires to assess Type D personality (14-item Type D Personality Scale [DS14]), health status (Minnesota Living with Heart Failure Questionnaire [MLWHFQ]), depressive symptoms (Center for Epidemiological Studies Depression Scale [CES-D]) and mood status (Global Mood Scale [GMS]) when visiting an outpatient heart failure clinic. Information on clinical variables was obtained from patients' medical records.
Type D patients were more likely to experience impairment in health status (18/38=47%) as compared to non-Type Ds (11/46=24%), P=0.027. They also more often reported symptoms of depression; namely 18 of 38=47% versus 6 of 46=13%, P=0.001. When controlling for severity and etiology of CHF, age and gender, Type D remained a significant associate of impaired health status [odds ratio (OR) 3.0, 95% confidence interval (CI) 1.12-7.78] and depressive symptoms (OR 6.3, 95% CI 2.08-19.12).
Type D was associated with impaired health status and increased depressive symptoms in CHF patients. These preliminary findings demonstrate the value of including personality factors in CHF research.
慢性心力衰竭(CHF)是一种严重疾病,与健康状况受损及抑郁症状的高患病率相关。迄今为止,关于CHF患者健康状况及抑郁症状的决定因素知之甚少。因此,本研究的目的是评估D型人格是否与心力衰竭患者的健康状况受损及抑郁症状增加相关,且独立于疾病特征。
84例收缩性CHF患者(63例男性和21例女性,平均年龄=65.9±12.1岁)在门诊心力衰竭诊所就诊时完成了四份问卷,以评估D型人格(14项D型人格量表[DS14])、健康状况(明尼苏达心力衰竭生活问卷[MLWHFQ])、抑郁症状(流行病学研究中心抑郁量表[CES-D])和情绪状态(总体情绪量表[GMS])。从患者病历中获取临床变量信息。
与非D型患者(11/46=24%)相比,D型患者更有可能出现健康状况受损(18/38=47%),P=0.027。他们也更常报告抑郁症状;即38例中的18例=47%,而46例中的6例=13%,P=0.001。在控制CHF的严重程度、病因、年龄和性别后,D型人格仍然是健康状况受损[比值比(OR)3.0,95%置信区间(CI)1.12-7.78]和抑郁症状(OR 6.3,95%CI 2.08-19.12)的显著相关因素。
D型人格与CHF患者的健康状况受损及抑郁症状增加相关。这些初步发现证明了在CHF研究中纳入人格因素具有重要价值。