Typ D-Persönlichkeit und Reha-Erfolg in der stationären Rehabilitation

The type D personality (distressed personality), charactarized by negative affectivity and social inihibition, has been shown by Denollet et al. as an independent predictor of poor quality of life and higher risk of mortality for patients with coronary heart disease. The purpose of this study was to examine the effect of cardiac rehabilitation in type D patients. We postulated an impaired benefit of cardiac rehabilitation in type D. The research includes psychological and somatic variables. We examined male and female patients (N=344) with heart disease on the effect of cardiac rehabilitation on anxiety, depression (HADS-D), left ventricular function (LVEF), and exercise tolerance (Watt-Ergometerleistung). Type D was assessed by the German version of the Type D scale (DS14). Results: 29,16% of the cardiac patients were classified as type D. There were no kinds of significant gender differences. Type D patients reported a higher level of anxiety and depression at the end of their rehabilitation treatment. In comparison to patients, who reported high levels in anxiety and depression at baseline, type D patients showed lower levels of depression and anxiety at the end of cardiac treatment. Hence, the decrease in anxiety and depression in patients with high depression and anxiety at baseline is higher than in type D. In our research type D had no significant effect on left ventricular function or on exercise tolerance. Only anxiety had a protective effect on left ventricular function and a high level of depression at baseline was associated with less excercise tolerance. Type D benefits less on emotional well-being despite appropriate cardiac treatment in cardiac rehabilitation. It seems promising to provide special psychological treatment for type D patients.