Objective: Distressed (Type D) personality - the combination of negative affectivity (NA) and social inhibition (SI) – has been associated with negative outcome in coronary artery disease (CAD) patients. Relatively higher rates of CAD has been found in Northern Norway compared to national and international figures. However, few studies have focused on psychological factors in CAD patients from this region. We found no previous study of Type D in a Norwegian patient population.
Methods: In this cross-sectional study we tested a Norwegian translation of the standard instrument measuring Type D (DS14) in a survey of patients receiving coronary revascularisation treatment at the University hospital of Northern Norway.
Results: A total of 432 patients (62% response rate) answered a questionnaire at 3-15 months following discharge. 229 had CABG (Coronary Artery Bypass Graft surgery)and 203 had PCI (Percutaneous Coronary Intervention) treatment. The majority were men (78%), mean age 60 years old. Factor analysis of DS14 produced two factors with high inter-item reliability, corresponding with the NA and SI dimensions. Type D was associated with anxiety, depression, and passive coping. The NA scale correlated positively with depression, anxiety, and passive coping. The SI scale correlated positively with depression and anxiety, and negatively with active coping. Applying the recommended cut-off level (NA≥10 and SI≥10), only 18% were classified as Type D. This is relatively low compared to what has been reported elsewhere. The prevalence of Type D was higher among women (26%) than among men (15.5%), and negatively correlated with time since treatment.
Conclusions: Results indicate that the Norwegian DS14 has acceptable psychometric properties. A relatively low percentage of patients could be classified as Type D personalities. The variation in Type D prevalence among studies suggesting potential cultural differences needs further elucidation.