Smith Otto R F, Pedersen Susanne S, Van Domburg Ron T, Denollet Johan
CoRPS - Center of Research for Psychology on Somatic diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.
Eur J Cardiovasc Prev Rehabil. 2008 Oct;15(5):583-8. doi: 10.1097/HJR.0b013e3283083e17.
Symptoms of fatigue and depression are prevalent across stages of ischemic heart disease (IHD). We examined (i) the effect of both the IHD stage and type-D personality on fatigue and depressive symptoms at 12-month follow-up, and (ii) whether the effect of type-D personality on these symptoms is moderated by IHD stage.
Two different samples of patients were included to represent IHD stage: 401 percutaneous coronary intervention patients (early-stage IHD) and 105 ischemic chronic heart failure patients (end-stage IHD) completed the DS14 Type-D Scale at baseline. Logistic regression analysis was used to examine the impact of IHD stage and type-D personality on fatigue and depression at follow-up.
Disease stage was neither associated with symptoms of fatigue (P=0.99) nor depression (P=0.29) at 12 months. In contrast, type-D personality was shown to predict both symptoms of fatigue [odds ratio (OR)=2.96; 95% confidence interval (CI): 1.92-4.58, P<0.001] and depression (OR=4.91; 95% CI: 3.16-7.65, P<0.001) at follow-up; the effect of type-D personality on these symptoms was not moderated by disease stage. In multivariable analysis, type-D remained a significant predictor of symptoms of fatigue (OR=3.14; 95% CI: 1.98-4.99, P<0.001) and depression (OR=5.90; 95% CI: 3.60-9.67, P<0.001), also after controlling for symptom levels at baseline.
Type-D personality but not disease stage predicted symptoms of fatigue and depression at 12-month follow-up.
疲劳和抑郁症状在缺血性心脏病（IHD）各阶段均很常见。我们研究了：（i）在12个月随访时IHD阶段和D型人格对疲劳和抑郁症状的影响；（ii）IHD阶段是否会调节D型人格对这些症状的影响。
纳入两个不同样本的患者以代表IHD阶段：401例接受经皮冠状动脉介入治疗的患者（IHD早期）和105例缺血性慢性心力衰竭患者（IHD终末期）在基线时完成了DS14 D型量表。采用逻辑回归分析来研究IHD阶段和D型人格对随访时疲劳和抑郁的影响。
在12个月时，疾病阶段与疲劳症状（P = 0.99）和抑郁症状（P = 0.29）均无关联。相比之下，D型人格被证明可预测随访时的疲劳症状[比值比（OR）= 2.96；95%置信区间（CI）：1.92 - 4.58，P < 0.001]和抑郁症状（OR = 4.91；95% CI：3.16 - 7.65，P < 0.001）；D型人格对这些症状的影响未被疾病阶段所调节。在多变量分析中，即使在控制了基线时的症状水平后，D型人格仍然是疲劳症状（OR = 3.14；95% CI：1.98 - 4.99，P < 0.001）和抑郁症状（OR = 5.90；95% CI：3.60 - 9.67，P < 0.001）的显著预测因素。
在12个月随访时，是D型人格而非疾病阶段预测了疲劳和抑郁症状。
