Symptoms of fatigue and depression in ischemic heart disease are driven by personality characteristics rather than disease stage: a comparison of CAD and CHF patients

• Published in: European journal of cardiovascular prevention and rehabilitation 2008-10, Vol.15 (5), p.583-588
• Main Authors: Smith, Otto R.F., Pedersen, Susanne S., Van Domburg, Ron T., Denollet, Johan
• Format: Article
• Language: English
• Subjects: Aged; Coronary Artery Disease - complications; Coronary Artery Disease - psychology; Depression - etiology; Disease Progression; Fatigue - etiology; Female; Heart Failure - complications; Heart Failure - psychology; Humans; Logistic Models; Male; Middle Aged; Myocardial Ischemia - complications; Myocardial Ischemia - psychology; Odds Ratio; Personality; Retrospective Studies; Time Factors
• ISSN: 2047-4873; 1741-8267; 2047-4881
• DOI: 10.1097/HJR.0b013e3283083e17

Background Symptoms of fatigue and depression are prevalent across stages of ischemic heart disease (IHD). We examined (i) the effect of both the IHD stage and type-D personality on fatigue and depressive symptoms at 12-month follow-up, and (ii) whether the effect of type-D personality on these symptoms is moderated by IHD stage. Methods Two different samples of patients were included to represent IHD stage: 401 percutaneous coronary intervention patients (early-stage IHD) and 105 ischemic chronic heart failure patients (end-stage IHD) completed the DS14 Type-D Scale at baseline. Logistic regression analysis was used to examine the impact of IHD stage and type-D personality on fatigue and depression at follow-up. Results Disease stage was neither associated with symptoms of fatigue (P = 0.99) nor depression (P = 0.29) at 12 months. In contrast, type-D personality was shown to predict both symptoms of fatigue [odds ratio (OR) = 2.96; 95% confidence interval (CI): 1.92–4.58, P < 0.001] and depression (OR = 4.91; 95% CI: 3.16–7.65, P < 0.001) at follow-up; the effect of type-D personality on these symptoms was not moderated by disease stage. In multivariable analysis, type-D remained a significant predictor of symptoms of fatigue (OR = 3.14; 95% CI: 1.98–4.99, P < 0.001) and depression (OR = 5.90; 95% CI: 3.60–9.67, P < 0.001), also after controlling for symptom levels at baseline. Conclusion Type-D personality but not disease stage predicted symptoms of fatigue and depression at 12-month follow-up.