Decreased physical effort, fatigue, and mental distress in patients with coronary artery disease

Importance of personality-related differences

A. Bunevicius, J. Brozaitiene, M. Staniute, V. Gelziniene, I. Duoneliene, V.J.M. Pop, R. Bunevicius, J. Denollet

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
Identification of cardio-toxic psychological symptoms in coronary artery disease (CAD) patients is important.
Purpose
We examined the association of negative affectivity (NA), social inhibition (SI), and their combination in the distressed (Type D) personality with functional status, fatigue, and mental distress in CAD patients.
Method
Following acute coronary syndrome, 690 consecutive CAD patients agreed to participate in this cross-sectional study and were evaluated for clinical characteristics, including left ventricular ejection fraction (LVEF), and for NA, SI, and Type D personality (i.e., NA and SI; DS14 scale) when they entered a cardiac rehabilitation program in Lithuania. Patient-centered outcomes included functional status (bicycle ergometer), symptoms of fatigue (Multidimensional Fatigue Inventory-20), and mental distress (Beck Depression Inventory–II and Hospital Anxiety and Depression Scale).
Results
The reference subgroup (neither NA nor SI) included 34 % of patients; 13 % had NA only, 19 % had SI only, and 34 % had Type D profile. Type D patients had worse functional status, and Type D patients and NA-only patients had higher symptom levels of fatigue and mental distress. In multivariate regression models that included LVEF, clinical characteristics, and depressive symptoms, Type D personality was an independent predictor of decreased exercise capacity (OR = 1.77, 95 % CI 1.06–2.95, p = .03) and decreased motivation for activity (OR = 3.14, 95 % CI 1.73–5.73, p < .001). Type D, NA, and SI were also independent predictors of mental distress.
Conclusions
Type D personality traits independently predicted poor functional status and worse patient-centered outcomes independently from LVEF and depression. Further studies exploring personality-related differences in cardiovascular outcomes are needed.Keywords: Coronary artery disease, Type D personality, Outcomes, Functional status
Original languageEnglish
Pages (from-to)240-247
JournalInternational Journal of Behavioral Medicine
Volume21
Issue number2
DOIs
Publication statusPublished - 2014

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Physical Exertion
Depression
Lithuania
Acute Coronary Syndrome
Cross-Sectional Studies
Exercise
Equipment and Supplies

Cite this

@article{a0db98a519144d6589df82168356c2e4,
title = "Decreased physical effort, fatigue, and mental distress in patients with coronary artery disease: Importance of personality-related differences",
abstract = "BackgroundIdentification of cardio-toxic psychological symptoms in coronary artery disease (CAD) patients is important.PurposeWe examined the association of negative affectivity (NA), social inhibition (SI), and their combination in the distressed (Type D) personality with functional status, fatigue, and mental distress in CAD patients.MethodFollowing acute coronary syndrome, 690 consecutive CAD patients agreed to participate in this cross-sectional study and were evaluated for clinical characteristics, including left ventricular ejection fraction (LVEF), and for NA, SI, and Type D personality (i.e., NA and SI; DS14 scale) when they entered a cardiac rehabilitation program in Lithuania. Patient-centered outcomes included functional status (bicycle ergometer), symptoms of fatigue (Multidimensional Fatigue Inventory-20), and mental distress (Beck Depression Inventory–II and Hospital Anxiety and Depression Scale).ResultsThe reference subgroup (neither NA nor SI) included 34 {\%} of patients; 13 {\%} had NA only, 19 {\%} had SI only, and 34 {\%} had Type D profile. Type D patients had worse functional status, and Type D patients and NA-only patients had higher symptom levels of fatigue and mental distress. In multivariate regression models that included LVEF, clinical characteristics, and depressive symptoms, Type D personality was an independent predictor of decreased exercise capacity (OR = 1.77, 95 {\%} CI 1.06–2.95, p = .03) and decreased motivation for activity (OR = 3.14, 95 {\%} CI 1.73–5.73, p < .001). Type D, NA, and SI were also independent predictors of mental distress.ConclusionsType D personality traits independently predicted poor functional status and worse patient-centered outcomes independently from LVEF and depression. Further studies exploring personality-related differences in cardiovascular outcomes are needed.Keywords: Coronary artery disease, Type D personality, Outcomes, Functional status",
author = "A. Bunevicius and J. Brozaitiene and M. Staniute and V. Gelziniene and I. Duoneliene and V.J.M. Pop and R. Bunevicius and J. Denollet",
year = "2014",
doi = "10.1007/s12529-013-9299-9",
language = "English",
volume = "21",
pages = "240--247",
journal = "International Journal of Behavioral Medicine",
issn = "1070-5503",
publisher = "Springer",
number = "2",

}

Decreased physical effort, fatigue, and mental distress in patients with coronary artery disease : Importance of personality-related differences. / Bunevicius, A.; Brozaitiene, J.; Staniute, M.; Gelziniene, V.; Duoneliene, I.; Pop, V.J.M.; Bunevicius, R.; Denollet, J.

In: International Journal of Behavioral Medicine, Vol. 21, No. 2, 2014, p. 240-247.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Decreased physical effort, fatigue, and mental distress in patients with coronary artery disease

T2 - Importance of personality-related differences

AU - Bunevicius, A.

AU - Brozaitiene, J.

AU - Staniute, M.

AU - Gelziniene, V.

AU - Duoneliene, I.

AU - Pop, V.J.M.

AU - Bunevicius, R.

AU - Denollet, J.

PY - 2014

Y1 - 2014

N2 - BackgroundIdentification of cardio-toxic psychological symptoms in coronary artery disease (CAD) patients is important.PurposeWe examined the association of negative affectivity (NA), social inhibition (SI), and their combination in the distressed (Type D) personality with functional status, fatigue, and mental distress in CAD patients.MethodFollowing acute coronary syndrome, 690 consecutive CAD patients agreed to participate in this cross-sectional study and were evaluated for clinical characteristics, including left ventricular ejection fraction (LVEF), and for NA, SI, and Type D personality (i.e., NA and SI; DS14 scale) when they entered a cardiac rehabilitation program in Lithuania. Patient-centered outcomes included functional status (bicycle ergometer), symptoms of fatigue (Multidimensional Fatigue Inventory-20), and mental distress (Beck Depression Inventory–II and Hospital Anxiety and Depression Scale).ResultsThe reference subgroup (neither NA nor SI) included 34 % of patients; 13 % had NA only, 19 % had SI only, and 34 % had Type D profile. Type D patients had worse functional status, and Type D patients and NA-only patients had higher symptom levels of fatigue and mental distress. In multivariate regression models that included LVEF, clinical characteristics, and depressive symptoms, Type D personality was an independent predictor of decreased exercise capacity (OR = 1.77, 95 % CI 1.06–2.95, p = .03) and decreased motivation for activity (OR = 3.14, 95 % CI 1.73–5.73, p < .001). Type D, NA, and SI were also independent predictors of mental distress.ConclusionsType D personality traits independently predicted poor functional status and worse patient-centered outcomes independently from LVEF and depression. Further studies exploring personality-related differences in cardiovascular outcomes are needed.Keywords: Coronary artery disease, Type D personality, Outcomes, Functional status

AB - BackgroundIdentification of cardio-toxic psychological symptoms in coronary artery disease (CAD) patients is important.PurposeWe examined the association of negative affectivity (NA), social inhibition (SI), and their combination in the distressed (Type D) personality with functional status, fatigue, and mental distress in CAD patients.MethodFollowing acute coronary syndrome, 690 consecutive CAD patients agreed to participate in this cross-sectional study and were evaluated for clinical characteristics, including left ventricular ejection fraction (LVEF), and for NA, SI, and Type D personality (i.e., NA and SI; DS14 scale) when they entered a cardiac rehabilitation program in Lithuania. Patient-centered outcomes included functional status (bicycle ergometer), symptoms of fatigue (Multidimensional Fatigue Inventory-20), and mental distress (Beck Depression Inventory–II and Hospital Anxiety and Depression Scale).ResultsThe reference subgroup (neither NA nor SI) included 34 % of patients; 13 % had NA only, 19 % had SI only, and 34 % had Type D profile. Type D patients had worse functional status, and Type D patients and NA-only patients had higher symptom levels of fatigue and mental distress. In multivariate regression models that included LVEF, clinical characteristics, and depressive symptoms, Type D personality was an independent predictor of decreased exercise capacity (OR = 1.77, 95 % CI 1.06–2.95, p = .03) and decreased motivation for activity (OR = 3.14, 95 % CI 1.73–5.73, p < .001). Type D, NA, and SI were also independent predictors of mental distress.ConclusionsType D personality traits independently predicted poor functional status and worse patient-centered outcomes independently from LVEF and depression. Further studies exploring personality-related differences in cardiovascular outcomes are needed.Keywords: Coronary artery disease, Type D personality, Outcomes, Functional status

U2 - 10.1007/s12529-013-9299-9

DO - 10.1007/s12529-013-9299-9

M3 - Article

VL - 21

SP - 240

EP - 247

JO - International Journal of Behavioral Medicine

JF - International Journal of Behavioral Medicine

SN - 1070-5503

IS - 2

ER -