Increased vital exhaustion among type-D patients with ischemic heart disease

Objective: To investigate the prevalence of the "distressed personality" (type-D) in cardiac patients and to explore the relationships between type-D, gender, vital exhaustion and angina pectoris. Methods: A questionnaire was completed by 171 patients scheduled for coronary angiography (CAG) at baseline and again at 6 weeks following implementation of treatment with invasive procedures or medication. Results: Women were more vitally exhausted at baseline and more likely to be classified as type-D. Type-D patients scored higher on vital exhaustion independent of all other variables. Angina was related to vital exhaustion, but improvement in angina following intervention was not associated with improvement in vital exhaustion scores. Conclusion: Although medical interventions reduced angina, a concomitant decrease in vital exhaustion scores was not found. It is suggested that type-D may explain gender differences on distress. Clinical implications are discussed, including the importance of including personality factors in future research, as they have been shown to have independent prognostic value. (C) 2001 Elsevier Science Inc. All rights reserved.