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Depression and Type D personality represent different forms of distress in the Myocardial INfarction and Depression – Intervention Trial (MIND-IT)

Published online by Cambridge University Press:  12 August 2008

J. Denollet ,
P. de Jonge ,
A. Kuyper ,
A. H. Schene ,
J. P. van Melle ,
J. Ormel  and
A. Honig
J. Denollet*
Affiliation:
CoRPS – Center of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands
P. de Jonge
Affiliation:
CoRPS – Center of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands Department of Internal Medicine, UMCG, University of Groningen, The Netherlands Department of Psychiatry, UMCG, University of Groningen, The Netherlands
A. Kuyper
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
A. H. Schene
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
J. P. van Melle
Affiliation:
Department of Cardiology, UMCG, University of Groningen, The Netherlands
J. Ormel
Affiliation:
Department of Psychiatry, UMCG, University of Groningen, The Netherlands
A. Honig
Affiliation:
Department of Psychiatry, St Lucas Andreas Hospital, Amsterdam, The Netherlands
*
*Address for correspondence: J. Denollet, Ph.D., CoRPS, Department of Medical Psychology, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands. (Email: denollet@uvt.nl)
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Abstract

Background

We investigated whether depressive disorder and Type D personality refer to different forms of distress in the Myocardial INfarction and Depression – Intervention Trial (MIND-IT).

Method

A total of 1205 myocardial infarction (MI) patients were screened at 3, 6, 9 and 12 months post-MI; those with a Beck Depression Inventory (BDI) score ⩾10 underwent the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Patients completed the DS14 measure of Type D personality at 12 months and were stratified to one of four subgroups: depressed/Type D, depressed/non-Type D, non-depressed/Type D, or non-distressed.

Results

Two hundred and six (17%) patients were diagnosed with depression and 224 (19%) with Type D. Only 7% (n=90) had both forms of distress, and 60% of Type D patients were free of depression in the first year post-MI. Type D moderated the relationship between depressive and cardiac disorder. Depressed patients without Type D had the worst clinical status (left ventricular dysfunction, heart failure, Killip class ⩾2) as compared to other patients, whereas depressed patients with a Type D personality did not differ in clinical status from non-distressed patients. Contrasting ‘pure’ Type D and depression subgroups showed that Type D patients without depression were less likely to have left ventricular dysfunction [odds ratio (OR) 0.47, 95% confidence interval (CI) 0.35–0.65, p<0.0001] than depressed patients without Type D.

Conclusions

Depression and Type D refer to different forms of distress in post-MI patients; most Type D patients display non-psychiatric levels of distress and Type D moderates the relationship between depressive and cardiac disorder. Different depression/Type D subgroups may be involved in the prediction of cardiac prognosis.

Keywords

Depressionheart failuremyocardial infarctionType D personality
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 5 , May 2009 , pp. 749 - 756
Copyright
Copyright © Cambridge University Press 2008

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