Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy.
Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy.
J Affect Disord. 2014 Feb;155:194-9. doi: 10.1016/j.jad.2013.10.052. Epub 2013 Nov 7.
Type D personality (TDP) has been proposed as a risk factor for the development of depressive symptoms after an acute coronary syndrome (ACS). However, contrasting findings emerged about its predicting power on the onset of depression, since an overlap between TDP and depressive symptoms has been proposed. The present study was aimed to verify whether TDP predicts the development of a depressive disorder in the 6 months after the discharge from hospital.
Two hundred fifty consecutive patients were recruited, at the Coronary Intensive Care Unit at the University Hospital of Parma, who were both presenting their first ACS and had no history of depression. The presence and the severity of major (MD) and minor (md) depression were evaluated with the Primary Care Evaluation of Mental Disorders (PRIME-MD) and the Hospital Anxiety and Depression Scale (HADS) respectively. Type D Personality was assessed with the DS14, both at baseline and at 1, 2, 4 and 6 month follow ups.
Out of 250 subjects (81.2% males), MD was diagnosed in 12 patients (4.8%) and md in 18 patients (7.2%). At baseline risk factors for a post-ACS depressive disorder were HADS depression scores, whereas TDP, or its subscales, did not showed any effect.
The small amount of patients with incidence of depression, due to highly selective inclusion criteria, tempers the reliability of our results.
Our data suggests that TDP does not predict the development of depressive disorders in never-depressed patients at their first ACS, when the baseline depression severity was controlled.
有人提出,D 型人格(TDP)是急性冠状动脉综合征(ACS)后抑郁症状发展的一个风险因素。然而,关于它对抑郁发作的预测能力,出现了相互矛盾的发现,因为有人提出 TDP 和抑郁症状之间存在重叠。本研究旨在验证 TDP 是否可以预测出院后 6 个月内是否会发生抑郁障碍。
在帕尔马大学医院的冠心病重症监护病房,连续招募了 250 名首次出现 ACS 且无抑郁病史的患者。使用初级保健精神疾病评估(PRIME-MD)和医院焦虑抑郁量表(HADS)分别评估主要(MD)和次要(md)抑郁的存在和严重程度。分别在基线以及 1、2、4 和 6 个月随访时,使用 DS14 评估 TDP。
在 250 名患者(81.2%为男性)中,12 名患者(4.8%)被诊断为 MD,18 名患者(7.2%)为 md。在基线时,与 ACS 后抑郁障碍相关的危险因素是 HADS 抑郁评分,而 TDP 或其亚量表则没有显示出任何影响。
由于高度选择性的纳入标准,患有抑郁障碍的患者数量较少,影响了我们结果的可靠性。
我们的数据表明,在首次 ACS 且基线抑郁严重程度得到控制的情况下,TDP 不能预测从未抑郁的患者中抑郁障碍的发生。