تیپ شخصیتی D با اختلال کیفیت زندگی مرتبط با سلامت 7 سال پس از پیوند قلب همراه است

Objective Health-related quality of life (HRQoL) following transplantation is gaining importance as an endpoint, but little is known about the role of normal personality traits as a determinant of HRQoL in this patient group. We investigated whether Type D personality (tendency to experience increased negative emotions paired with the nonexpression of these emotions) was associated with impaired HRQoL in heart transplant recipients. Methods Data were collected from all surviving heart transplant recipients ≥21 years of age (n=186) with a mean (S.D.) of 7 (5) years following transplantation. Patients completed the Short-Form Health Survey 36 (SF-36) and the Type D Scale (DS14). Clinical data were obtained from the medical records. Results Of the 186 patients, 18% had a Type D personality. Type D patients had significantly worse scores on the Physical Component scale (PCS) (P=.04) and the Mental Component scale (MCS) (P<.001) of the SF-36 and all the SF-36 subdomains (all P<.01) compared with non-Type D patients, except for Bodily Pain. Type D personality remained an independent determinant of impaired PCS [odds ratio (OR), 3.62; 95% confidence interval (CI), 1.25–10.45] and MCS (OR, 6.13; 95% CI, 2.23–16.83) and six of the eight subscales of the SF-36, adjusting for demographic and clinical characteristics. Conclusions Type D personality was associated with more than a three- to six-fold increased risk of impaired HRQoL in heart transplant recipients, showing that the Type D personality construct also has value in heart transplant recipients. The adoption of a personality approach may lead to improved risk stratification in research and clinical practice in this patient group.

Since the survival rate for heart transplant recipients has improved to 60% at 7 years, health-related quality of life (HRQoL) following transplantation has become an important endpoint [1]. The study of HRQoL in this patient group is not only important because it may lead to improved patient-centered care [2], HRQoL has also been associated with increased risk of mortality in patients with cardiovascular disease (CVD) [3], [4] and [5]. In order to identify subgroups of recipients at risk for impaired HRQoL and to enhance secondary prevention in these high-risk patients, knowledge of the determinants of HRQoL is important. Knowledge of these determinants may also close the gap between research and clinical practice [2]. In this context, a personality approach may provide a particularly valuable framework, as personality has much explanatory power of individual differences in psychological distress, HRQoL, and adverse health outcomes [6] and [7]. From a screening point of view, a personality approach is also advantageous, since personality traits exert stable effects on behaviour, whereas mood states (e.g., anxiety and depression) are transient and fluctuate over time. A personality approach has already been used in the field of heart transplantation, and personality factors have been associated with posttransplant compliance, morbidity, and mortality [8], [9] and [10]. Emphasis, however, has primarily been on personality disorders or on single, normal, personality traits, rather than the interaction of traits. In addition, few studies have investigated the impact of personality on HRQoL.