CoRPS-Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands.
Cleve Clin J Med. 2011 Aug;78 Suppl 1:S13-9. doi: 10.3949/ccjm.78.s1.02.
General distress, shared across depression, anxiety and anger, partly accounts for the link between mind and heart. The type D (distressed) personality profile identifies individuals who are particularly vulnerable to the adverse effect of general distress. Type D individuals frequently experience negative emotions and are socially inhibited. This profile is more stable than that associated with episodes of clinical depression and describes the chronic nature of distress in some patients. Type D may also partly account for the effect of emotional distress on cardiac prognosis. Type D is associated with a threefold increased risk of adverse cardiovascular outcomes, even after adjustment for depression. This relationship is less obvious in patients with heart failure. Plausible pathways linking type D to cardiovascular complications include hypothalamic-pituitary-adrenal-axis hyperreactivity, autonomic and inflammatory dysregulation, and increased oxidative stress. Research needs to further clarify these pathways and investigate whether type D patients may benefit from closer monitoring of risk factors and a personalized approach to behavioral intervention. The DS14 is a brief, well-validated measure of type D that could be incorporated into clinical research and practice to identify high-risk patients.
一般的苦恼，在抑郁、焦虑和愤怒中都有体现，这在一定程度上解释了心理和心脏之间的联系。D 型（苦恼）人格特征识别出那些特别容易受到一般苦恼的不良影响的个体。D 型个体经常经历负面情绪，并在社交上受到抑制。这种特征比与临床抑郁症发作相关的特征更稳定，描述了一些患者苦恼的慢性性质。D 型也可能部分解释了情绪困扰对心脏预后的影响。即使在调整抑郁因素后，D 型也与不良心血管结局的风险增加三倍相关。在心力衰竭患者中，这种关系不那么明显。将 D 型与心血管并发症联系起来的可能途径包括下丘脑-垂体-肾上腺轴的高反应性、自主神经和炎症失调以及氧化应激增加。研究需要进一步阐明这些途径，并探讨 D 型患者是否可能受益于更密切的危险因素监测和个性化的行为干预方法。DS14 是一种简短、经过充分验证的 D 型测量工具，可以纳入临床研究和实践中，以识别高风险患者。
