Type D personality as a cardiovascular risk marker in the general population: results from the Gutenberg health study

Psychother Psychosom. 2012;81(2):108-17. doi: 10.1159/000331776. Epub 2012 Jan 18.

Abstract

Background: Type D personality is considered as an independent risk factor for morbidity and mortality in cardiovascular patients and a vulnerability factor for distress in the general population. Because representative community studies are rare, we sought to determine the prevalence of type D personality and its relationship with demographic characteristics, different features of mental disorders, cardiovascular risk factors, health behavior, endothelial function and cardiovascular biomarkers in the general population.

Methods: The prevalence of type D personality and its correlates were analyzed cross-sectionally in a population-based sample of 5,000 Mid-Europeans aged 35-74 years from the Gutenberg Health Study.

Results: The prevalence of type D personality was 22.2% without remarkable differences in sex distribution. Type D subjects were characterized by lower socioeconomic status, lack of a partnership, increased depression, anxiety, depersonalization and health care utilization. Despite its strong association with mental disorders, type D personality emerged as psychometrically distinct. Although type D personality was independently associated with coronary heart disease (OR = 1.54, p = 0.044), no associations with traditional cardiovascular risk factors were found independently from depression or anxiety.

Conclusions: Although type D personality is strongly associated with depression, anxiety, impaired mental and somatic health status, and increased health care utilization, the type D construct seems to comprise dysfunctional personality patterns not covered by depression and anxiety scales. Beyond these associations, the pathways of the cardiotoxic impact of type D personality remain to be elucidated. There is a need for prospective population studies on potential links between type D personality and cardiac disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anxiety / epidemiology*
  • Biomarkers / blood
  • Coronary Disease / epidemiology*
  • Depression / epidemiology*
  • Dyslipidemias / blood
  • Dyslipidemias / epidemiology
  • Endothelium / physiopathology
  • Female
  • Germany / epidemiology
  • Health Behavior*
  • Humans
  • Interview, Psychological
  • Life Style
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Personality Assessment
  • Personality Disorders / blood
  • Personality Disorders / epidemiology*
  • Personality Disorders / physiopathology
  • Personality*
  • Psychiatric Status Rating Scales
  • Stress, Psychological / epidemiology

Substances

  • Biomarkers