Abstract P207: Determinants of Individual Differences in Patient-Centered Outcomes: A Meta-analysis of Type D Personality and Health Status

Abstract

Background. Knowledge of the determinants of individual differences in patient-centered outcomes is essential to identify high-risk patients and improve secondary prevention. We evaluated the evidence on the distressed (Type D) personality as a potential determinant of patient-reported physical and mental health status in cardiovascular patients. Methods. A computerized search of the literature through PUBMED and PsychINFO (1995-October 2010) was performed and studies were selected that analyzed the association between Type D personality and health status or health-related quality of life in cardiovascular patients. Two separate meta-analyses were performed for the effect of Type D personality on physical and mental health status. Results. Of all identified studies, 23 met the selection criteria; 9 studies were excluded from the meta-analyses as they originated from the same dataset or had limited methodological quality. The meta-analyses showed that Type D personality was associated with a 2-fold increased odds for impaired physical health status (n=3865 patients, OR=2.04; 95%CI:1.67-2.48) and a 3-fold increased odds for impaired mental health status (n=3043 patients, OR=3.02; 95%CI:2.09-4.36). Subgroup analyses showed that the association between Type D personality and mental health status decreased when adjusting for baseline health status and/or depression. All but one of the nine studies not included in the meta-analyses confirmed an association between Type D personality and impaired health status. Conclusions . Type D personality was shown to be an independent associate of impaired physical and mental health status across various cardiovascular conditions. Physicians should be aware of Type D personality as a potential determinant of patient-reported health status in cardiovascular outcomes research.