Yamaguchi Daisuke, Izawa Atsushi, Matsunaga Yasuko
School of Health Sciences, Shinshu University, Japan.
Intern Med. 2020;59(13):1589-1595. doi: 10.2169/internalmedicine.3803-19. Epub 2020 Jul 1.
Objective Depression in patients with coronary artery disease (CAD) has been a risk factor for adverse cardiovascular events. However, personality types, strategies for coping with stressors, and their associations with depression have not been fully elucidated in patients with CAD. This study explored depression in patients with CAD and examined its association with personality types and coping strategies. Methods A prospective observational study of 89 patients with CAD was conducted between August 2016 and July 2018. The presence of depression and type D personality and types of coping strategies were measured one month after percutaneous coronary intervention. A logistic regression analysis was performed to identify characteristics associated with depression. Results Generally, the incidence of depression and type D personality was 55.1% and 44.9%, respectively. The incidence of depression in patients with type D and non-type D personality was 72.5% and 40.8%, respectively. Patients with type D personality coped less frequently using a planning strategy but frequently using a responsibility-shifting strategy. A logistic regression analysis showed that the presence of depression was significantly associated with type D personality and inversely associated with a planning strategy. Conclusion The high prevalence of depression in patients with CAD was associated with type D personality and a low rate of adoption of a planning strategy. Specific coping interventions in patients with CAD with type D personality may be potential targets for improving coping skills and preventing the development of depression.
目的 冠心病（CAD）患者的抑郁一直是不良心血管事件的危险因素。然而，CAD患者的人格类型、应对压力源的策略及其与抑郁的关联尚未完全阐明。本研究探讨了CAD患者的抑郁情况，并检验了其与人格类型和应对策略的关联。方法 2016年8月至2018年7月对89例CAD患者进行了一项前瞻性观察研究。在经皮冠状动脉介入治疗1个月后测量抑郁的存在情况、D型人格及应对策略类型。进行逻辑回归分析以确定与抑郁相关的特征。结果 总体而言，抑郁和D型人格的发生率分别为55.1%和44.9%。D型人格和非D型人格患者的抑郁发生率分别为72.5%和40.8%。D型人格患者较少使用计划策略应对，但经常使用责任转移策略。逻辑回归分析表明，抑郁的存在与D型人格显著相关，与计划策略呈负相关。结论 CAD患者中抑郁的高患病率与D型人格和计划策略的低采用率有关。对D型人格的CAD患者进行特定的应对干预可能是提高应对技能和预防抑郁发展的潜在目标。
