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

J. Denollet, P. de Jonge, A. Kuyper, A. H. Schene, J. P. van Melle, J. Ormel, A. Honig
2008 Psychological Medicine  
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 o10 underwent the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Patients completed the DS14 measure of Type D
more » ... 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 o2) 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.
doi:10.1017/s0033291708004157 pmid:18694538 fatcat:zp5twwaihnbszh6r4wbznqjuvu