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J Affect Disord. 2011 May;130(3):447-53. doi: 10.1016/j.jad.2010.10.044. Epub 2010 Nov 18.

The distressed (Type D) personality in both patients and partners enhances the risk of emotional distress in patients with an implantable cardioverter defibrillator.

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  • 1CoRPS-Department of Medical Psychology, Tilburg University, The Netherlands.



A subgroup of patients with an implantable cardioverter defibrillator (ICD) experiences emotional distress. This may be related to partner factors. We examined the impact of the personality of the partner (i.e., the distressed (Type D) personality) in combination with that of the patient on anxiety and depression levels in ICD patients.


Consecutively implanted ICD patients (N=281; 80.1% men; mean age=58.3±11.0) and their partners (N=281; 20.6% men; mean age=56.5±11.7) completed the Type D Scale at baseline; patients also completed the Hospital Anxiety and Depression Scale at baseline and 6 months post-implantation.


ANOVA for repeated measures, using the Type D main effects and the interaction effect, showed that the interaction time by Type D patient by Type D partner was significant (F((1,277))=7.0, p=.009) for depression as outcome, but not for anxiety (F((1,277))=3.1, p=.08). Post-hoc comparisons revealed that Type D patients with a Type D partner (n=23/281, 8.2%) experienced the highest depression levels compared to other personality combinations (all ps<.05).


The group of Type D patients with a Type D partner was rather small.


ICD patients with a Type D personality report more depressive symptoms, but not anxiety, if the partner also has a Type D personality. This may be due to poor communication and lack of emotional support in the relationship. These results emphasize the importance of taking into account the psychological profile of the partner in the management and care of the ICD patient, and to direct behavioural support not only at the ICD patient but also at the partner.

Copyright © 2010 Elsevier B.V. All rights reserved.

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