Yamaguchi Daisuke, Asano Yoshihiro, Kuwahara Koichiro, Izawa Atsushi
Division of Nursing, School of Health Sciences, Shinshu University, Matsumoto city, Nagano, Japan.
Department of Cardiovascular Medicine, School of Medicine, Shinshu University, Matsumoto city, Nagano, Japan.
PLoS One. 2025 Jan 13;20(1):e0316639. doi: 10.1371/journal.pone.0316639. eCollection 2025.
Type D personality, characterized by negative affectivity and social inhibition, has been associated with both the psychophysiology of coronary artery disease (CAD) and depressive disorders. However, few reports have described the impact of coping strategies in these patients. This study aimed to analyze the characteristics of type D personality and the coping strategies adopted by patients with CAD and to explore the factors associated with depressive tendencies during follow-up. Among 84 patients with CAD (median age 66.5 years, nine women) who underwent percutaneous coronary intervention (PCI), we examined pre-discharge characteristics for personality and coping strategies. We prospectively evaluated associations with the persistence or improvement of depressive tendencies at 9 months. Our findings revealed that persistence of depressive tendencies at 9 months was inversely associated with the adoption of the "planning" coping strategy (odds ratio [OR]: 0.80). We observed worsening depressive tendencies in patients with type D personality who transitioned from non-type D during follow-up. Conversely, improvement in depressive tendencies was associated with the adoption of "planning" (OR: 1.47), "evasive thinking" (OR: 1.47), and "positive interpretation" (OR: 1.43) coping strategies, and inversely associated with the adoption of the "abandonment or resignation" strategy (OR: 0.71). The persistence or improvement of depressive tendencies at 9 months post-PCI was associated with the adoption of specific coping strategies. Changes in type D personality during follow-up were associated with the status of depressive tendency. Personality-oriented treatment incorporating specific coping strategies may provide new strategies to prevent depression and improve care for patients with CAD.
D型人格以消极情感和社交抑制为特征，与冠状动脉疾病（CAD）的心理生理学以及抑郁症均有关联。然而，鲜有报告描述应对策略对这些患者的影响。本研究旨在分析CAD患者的D型人格特征及所采用的应对策略，并探索随访期间与抑郁倾向相关的因素。在84例行经皮冠状动脉介入治疗（PCI）的CAD患者（中位年龄66.5岁，9名女性）中，我们检查了出院前的人格和应对策略特征。我们前瞻性评估了9个月时与抑郁倾向持续或改善的相关性。我们的研究结果显示，9个月时抑郁倾向的持续与采用“计划”应对策略呈负相关（优势比[OR]：0.80）。我们观察到，随访期间从非D型人格转变为D型人格的患者，其抑郁倾向恶化。相反，抑郁倾向的改善与采用“计划”（OR：1.47）、“回避思维”（OR：1.47）和“积极解读”（OR：1.43）应对策略相关，与采用“放弃或听任”策略呈负相关（OR：0.71）。PCI术后9个月抑郁倾向的持续或改善与采用特定应对策略有关。随访期间D型人格的变化与抑郁倾向状况有关。纳入特定应对策略的以人格为导向的治疗可能为预防抑郁症和改善CAD患者的护理提供新策略。
