van den Broek Krista C, Martens Elisabeth J, Nyklícek Ivan, van der Voort Pepijn H, Pedersen Susanne S
CoRPS-Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, and Department of Cardiology, Catharina Hospital Eindhoven, The Netherlands.
J Psychosom Res. 2007 Jul;63(1):41-9. doi: 10.1016/j.jpsychores.2007.03.014.
The distressed (type D) personality is an emerging risk factor in coronary artery disease that has been associated with adverse prognosis, impaired health status, and emotional distress. Little is known about factors that may influence the impact of type-D personality on health outcomes. Therefore, the aim of this study was to determine the combined effect of type-D and not having a partner on symptoms of anxiety and depression.
Patients (n=554) hospitalized for acute myocardial infarction or implantable cardioverter defibrillator implantation completed the 14-item type-D Scale (DS14) during hospitalization and the State-Trait Anxiety Inventory and Beck Depression Inventory at 2 months follow-up.
Stratifying by personality and partner status showed that type-D patients without a partner had a higher risk of both anxiety [odds ratio (OR)=8.27; 95% confidence interval (CI)=2.50-27.32] and depressive symptoms (OR=6.74; 95% CI=2.19-20.76) followed by type-D patients with a partner (OR=3.73; 95% CI=2.16-6.45 and OR=3.81; 95% CI=2.08-6.99, respectively) and non-type-D patients without a partner (OR=2.04; 95% CI=1.05-3.96 and OR=3.03; 95% CI=1.46-6.31, respectively) compared to non-type-D patients with a partner, adjusting for demographic and clinical baseline characteristics, indicating a dose-response relationship.
Lack of a partner further exacerbated the risk of symptoms of anxiety and depression in the already distressed type-D patients. In clinical practice, it is important to identify type-D patients without a partner and carefully monitor them, as they may be less likely to alter health-related behaviors due to their increased levels of distress.
苦恼型（D型）人格是冠状动脉疾病中一种新出现的危险因素，与不良预后、健康状况受损和情绪困扰相关。对于可能影响D型人格对健康结局影响的因素，人们了解甚少。因此，本研究的目的是确定D型人格和没有伴侣对焦虑和抑郁症状的综合影响。
因急性心肌梗死或植入式心律转复除颤器植入而住院的患者（n = 554）在住院期间完成了14项D型量表（DS14），并在随访2个月时完成了状态-特质焦虑量表和贝克抑郁量表。
按人格和伴侣状况分层显示，没有伴侣的D型患者焦虑[优势比（OR）= 8.27；95%置信区间（CI）= 2.50 - 27.32]和抑郁症状（OR = 6.74；95% CI = 2.19 - 20.76）的风险更高，其次是有伴侣的D型患者（分别为OR = 3.73；95% CI = 2.16 - 6.45和OR = 3.81；95% CI = 2.08 - 6.99），与有伴侣的非D型患者相比，没有伴侣的非D型患者（分别为OR = 2.04；95% CI = 1.05 - 3.96和OR = 3.03；95% CI = 1.46 - 6.31），在调整人口统计学和临床基线特征后，显示出剂量反应关系。
没有伴侣进一步加剧了本就苦恼的D型患者的焦虑和抑郁症状风险。在临床实践中，识别没有伴侣的D型患者并仔细监测他们很重要，因为他们可能因苦恼程度增加而不太可能改变与健康相关的行为。
