Type D Personality as a Cardiovascular Risk Marker in the General Population: Results from the Gutenberg Health Study

• Published in: Psychotherapy and psychosomatics 2012-01, Vol.81 (2), p.108-117
• Main Authors: Beutel, M.E., Wiltink, J., Till, Y., Wild, P.S., Münzel, T., Ojeda, F.M., Zeller, T., Schnabel, R.B., Lackner, K., Blettner, M., Zwiener, I., Michal, M.
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Anxiety - epidemiology; Biological and medical sciences; Biomarkers - blood; Cardiology. Vascular system; Coronary Disease - epidemiology; Coronary heart disease; Depression; Depression - epidemiology; Dyslipidemias - blood; Dyslipidemias - epidemiology; Endothelium - physiopathology; Female; Germany - epidemiology; Health Behavior; Heart; Humans; Interview, Psychological; Life Style; Male; Medical sciences; Middle Aged; Mood disorders; Patient Acceptance of Health Care - statistics & numerical data; Personality; Personality Assessment; Personality Disorders - blood; Personality Disorders - epidemiology; Personality Disorders - physiopathology; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regular Article; Stress, Psychological - epidemiology
• ISSN: 0033-3190; 1423-0348
• DOI: 10.1159/000331776

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.