Is type-D a stable construct? An examination of type-D personality in patients before and after cardiac surgery

Objective: Type-D personality negative affectivity and social inhibition are related to poor prognosis in cardiovascular diseases. At present, little is known about type-D personality and its stability before and after cardiac surgery. Methods: One hundred twenty-six patients recommended for coronary bypass and/or valve surgery were examined at pre-surgery and 6 months post-surgery to investigate the stability of type-D (14-item Type-D Scale) and its relationship to anxiety, depression (Hospital Anxiety and Depression Scale) and quality of life (Short Form 12). Results: Preoperatively, 26% were assessed to have type-D, while only 11% fulfilled type-D criteria both pre- and post-surgery. Patients were assessed and identified as belonging to one of the four type-D groups: Stable type-D (11%), non-type-D (61%), type-D pre (15%), and type-D post (13%). In comparison to the stable non-type D group, the stable type-D reported more symptoms of anxiety, depression, lower physical quality of life post-surgery, and lower mental quality of life both pre- and post-surgery. When compared to the population at large, stable type-D had more symptoms of depression pre-surgery, and more anxiety as well as lower physical and mental quality of life pre- and post-surgery. Conclusion: Type-D diagnosis changed in nearly 60% of the cases post-surgery. Only those patients with stable type-D exhibited a relationship to emotional distress, such as anxiety and depression and reduced quality of life. Additional research on the critical cutoff scores and stability of type-D as it relates to critical life events would likely enhance our ability to more effectively diagnose and treat patients who are at high risk for insufficient coping. (C) 2010 Elsevier Inc. All rights reserved.