Association of Type D personality with increased vulnerability to depression

Is there a role for inflammation or endothelial dysfunction? - The Maastricht Study

F.E.P. van Dooren, Frans R J Verhey, Frans Pouwer, Casper G Schalkwijk, Simone J S Sep, Coen D A Stehouwer, Ronald M A Henry, Pieter C Dagnelie, Nicolaas C Schaper, Carla J H van der Kallen, Annemarie Koster, Miranda T Schram, J. Denollet

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
Type D personality – the combination of negative affectivity (NA) and social inhibition (SI) – has been associated with depression but little is known about underlying mechanisms. We examined whether (1) Type D is a vulnerability factor for depression in general, (2) Type D is associated with inflammation or endothelial dysfunction, and (3) these biomarkers alter the possible association between Type D and depression.
Methods
In the Maastricht Study, 712 subjects underwent assessment of NA, SI and Type D personality (DS14), depressive disorder (Mini-International Neuropsychiatric Interview) and depressive symptoms (Patient Health Questionnaire-9). Plasma biomarkers of inflammation (hsCRP, SAA, sICAM-1, IL-6, IL-8, TNF-α) and endothelial dysfunction (sVCAM-1, sICAM-1, E-selectin, vWF) were measured with sandwich immunoassays or ELISA and combined into standardized sumscores.
Results
Regarding personality, 49% of the study population was low in NA and SI, 22% had SI only, 12% NA only and 17% had Type D. Depressive disorder and depressive symptoms were significantly more prevalent in Type D versus the other three personality subgroups. Multivariable regression analyses showed that Type D was associated with inflammation (β=0.228, p=0.014) and endothelial dysfunction (β=0.216, p=0.022). After adjustment for these biomarkers, Type D remained independently associated with increased vulnerability to depressive disorder (OR=13.20, p<0.001) and depressive symptoms (β=3.87, p<0.001).LimitationsThe cross-sectional design restrained us to draw any conclusions on causality. The relatively low prevalence of depressive disorder restrained us to adjust for more potential confounders.
Conclusions
Type D personality may be a vulnerability factor for depression, irrespective of levels of inflammation or endothelial dysfunction. Future research should examine possible underlying mechanisms.
Original languageEnglish
Pages (from-to)118-125
JournalJournal of Affective Disorders
Volume189
DOIs
Publication statusPublished - 2016

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Depression
E-Selectin
Interleukin-8
Immunoassay
Interleukin-6
Interviews

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van Dooren, F.E.P. ; Verhey, Frans R J ; Pouwer, Frans ; Schalkwijk, Casper G ; Sep, Simone J S ; Stehouwer, Coen D A ; Henry, Ronald M A ; Dagnelie, Pieter C ; Schaper, Nicolaas C ; van der Kallen, Carla J H ; Koster, Annemarie ; Schram, Miranda T ; Denollet, J. / Association of Type D personality with increased vulnerability to depression : Is there a role for inflammation or endothelial dysfunction? - The Maastricht Study. In: Journal of Affective Disorders. 2016 ; Vol. 189. pp. 118-125.
@article{58d8ff751bfd437d98757ba7dbb75b77,
title = "Association of Type D personality with increased vulnerability to depression: Is there a role for inflammation or endothelial dysfunction? - The Maastricht Study",
abstract = "BackgroundType D personality – the combination of negative affectivity (NA) and social inhibition (SI) – has been associated with depression but little is known about underlying mechanisms. We examined whether (1) Type D is a vulnerability factor for depression in general, (2) Type D is associated with inflammation or endothelial dysfunction, and (3) these biomarkers alter the possible association between Type D and depression.MethodsIn the Maastricht Study, 712 subjects underwent assessment of NA, SI and Type D personality (DS14), depressive disorder (Mini-International Neuropsychiatric Interview) and depressive symptoms (Patient Health Questionnaire-9). Plasma biomarkers of inflammation (hsCRP, SAA, sICAM-1, IL-6, IL-8, TNF-α) and endothelial dysfunction (sVCAM-1, sICAM-1, E-selectin, vWF) were measured with sandwich immunoassays or ELISA and combined into standardized sumscores.ResultsRegarding personality, 49{\%} of the study population was low in NA and SI, 22{\%} had SI only, 12{\%} NA only and 17{\%} had Type D. Depressive disorder and depressive symptoms were significantly more prevalent in Type D versus the other three personality subgroups. Multivariable regression analyses showed that Type D was associated with inflammation (β=0.228, p=0.014) and endothelial dysfunction (β=0.216, p=0.022). After adjustment for these biomarkers, Type D remained independently associated with increased vulnerability to depressive disorder (OR=13.20, p<0.001) and depressive symptoms (β=3.87, p<0.001).LimitationsThe cross-sectional design restrained us to draw any conclusions on causality. The relatively low prevalence of depressive disorder restrained us to adjust for more potential confounders.ConclusionsType D personality may be a vulnerability factor for depression, irrespective of levels of inflammation or endothelial dysfunction. Future research should examine possible underlying mechanisms.",
author = "{van Dooren}, F.E.P. and Verhey, {Frans R J} and Frans Pouwer and Schalkwijk, {Casper G} and Sep, {Simone J S} and Stehouwer, {Coen D A} and Henry, {Ronald M A} and Dagnelie, {Pieter C} and Schaper, {Nicolaas C} and {van der Kallen}, {Carla J H} and Annemarie Koster and Schram, {Miranda T} and J. Denollet",
note = "Copyright {\circledC} 2015 Elsevier B.V. All rights reserved.",
year = "2016",
doi = "10.1016/j.jad.2015.09.028",
language = "English",
volume = "189",
pages = "118--125",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier",

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van Dooren, FEP, Verhey, FRJ, Pouwer, F, Schalkwijk, CG, Sep, SJS, Stehouwer, CDA, Henry, RMA, Dagnelie, PC, Schaper, NC, van der Kallen, CJH, Koster, A, Schram, MT & Denollet, J 2016, 'Association of Type D personality with increased vulnerability to depression: Is there a role for inflammation or endothelial dysfunction? - The Maastricht Study', Journal of Affective Disorders, vol. 189, pp. 118-125. https://doi.org/10.1016/j.jad.2015.09.028

Association of Type D personality with increased vulnerability to depression : Is there a role for inflammation or endothelial dysfunction? - The Maastricht Study. / van Dooren, F.E.P.; Verhey, Frans R J; Pouwer, Frans; Schalkwijk, Casper G; Sep, Simone J S; Stehouwer, Coen D A; Henry, Ronald M A; Dagnelie, Pieter C; Schaper, Nicolaas C; van der Kallen, Carla J H; Koster, Annemarie; Schram, Miranda T; Denollet, J.

In: Journal of Affective Disorders, Vol. 189, 2016, p. 118-125.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Association of Type D personality with increased vulnerability to depression

T2 - Is there a role for inflammation or endothelial dysfunction? - The Maastricht Study

AU - van Dooren, F.E.P.

AU - Verhey, Frans R J

AU - Pouwer, Frans

AU - Schalkwijk, Casper G

AU - Sep, Simone J S

AU - Stehouwer, Coen D A

AU - Henry, Ronald M A

AU - Dagnelie, Pieter C

AU - Schaper, Nicolaas C

AU - van der Kallen, Carla J H

AU - Koster, Annemarie

AU - Schram, Miranda T

AU - Denollet, J.

N1 - Copyright © 2015 Elsevier B.V. All rights reserved.

PY - 2016

Y1 - 2016

N2 - BackgroundType D personality – the combination of negative affectivity (NA) and social inhibition (SI) – has been associated with depression but little is known about underlying mechanisms. We examined whether (1) Type D is a vulnerability factor for depression in general, (2) Type D is associated with inflammation or endothelial dysfunction, and (3) these biomarkers alter the possible association between Type D and depression.MethodsIn the Maastricht Study, 712 subjects underwent assessment of NA, SI and Type D personality (DS14), depressive disorder (Mini-International Neuropsychiatric Interview) and depressive symptoms (Patient Health Questionnaire-9). Plasma biomarkers of inflammation (hsCRP, SAA, sICAM-1, IL-6, IL-8, TNF-α) and endothelial dysfunction (sVCAM-1, sICAM-1, E-selectin, vWF) were measured with sandwich immunoassays or ELISA and combined into standardized sumscores.ResultsRegarding personality, 49% of the study population was low in NA and SI, 22% had SI only, 12% NA only and 17% had Type D. Depressive disorder and depressive symptoms were significantly more prevalent in Type D versus the other three personality subgroups. Multivariable regression analyses showed that Type D was associated with inflammation (β=0.228, p=0.014) and endothelial dysfunction (β=0.216, p=0.022). After adjustment for these biomarkers, Type D remained independently associated with increased vulnerability to depressive disorder (OR=13.20, p<0.001) and depressive symptoms (β=3.87, p<0.001).LimitationsThe cross-sectional design restrained us to draw any conclusions on causality. The relatively low prevalence of depressive disorder restrained us to adjust for more potential confounders.ConclusionsType D personality may be a vulnerability factor for depression, irrespective of levels of inflammation or endothelial dysfunction. Future research should examine possible underlying mechanisms.

AB - BackgroundType D personality – the combination of negative affectivity (NA) and social inhibition (SI) – has been associated with depression but little is known about underlying mechanisms. We examined whether (1) Type D is a vulnerability factor for depression in general, (2) Type D is associated with inflammation or endothelial dysfunction, and (3) these biomarkers alter the possible association between Type D and depression.MethodsIn the Maastricht Study, 712 subjects underwent assessment of NA, SI and Type D personality (DS14), depressive disorder (Mini-International Neuropsychiatric Interview) and depressive symptoms (Patient Health Questionnaire-9). Plasma biomarkers of inflammation (hsCRP, SAA, sICAM-1, IL-6, IL-8, TNF-α) and endothelial dysfunction (sVCAM-1, sICAM-1, E-selectin, vWF) were measured with sandwich immunoassays or ELISA and combined into standardized sumscores.ResultsRegarding personality, 49% of the study population was low in NA and SI, 22% had SI only, 12% NA only and 17% had Type D. Depressive disorder and depressive symptoms were significantly more prevalent in Type D versus the other three personality subgroups. Multivariable regression analyses showed that Type D was associated with inflammation (β=0.228, p=0.014) and endothelial dysfunction (β=0.216, p=0.022). After adjustment for these biomarkers, Type D remained independently associated with increased vulnerability to depressive disorder (OR=13.20, p<0.001) and depressive symptoms (β=3.87, p<0.001).LimitationsThe cross-sectional design restrained us to draw any conclusions on causality. The relatively low prevalence of depressive disorder restrained us to adjust for more potential confounders.ConclusionsType D personality may be a vulnerability factor for depression, irrespective of levels of inflammation or endothelial dysfunction. Future research should examine possible underlying mechanisms.

U2 - 10.1016/j.jad.2015.09.028

DO - 10.1016/j.jad.2015.09.028

M3 - Article

VL - 189

SP - 118

EP - 125

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -