Abstract
Type D personality has been shown to increase the risk for cardiovascular events in patients with coronary artery disease (CAD). We investigated the effects of expanded cardiac rehabilitation on type D score and psychosocial characteristics in 224 CAD patients randomised to either expanded cardiac rehabilitation (stress management, increased physical training, stay at a “Patient Hotel” after discharge and cooking sessions), or routine rehabilitation. Follow-up was 1 year. At baseline patients with a high type D score [patients in the upper quartile of type D score (Q4) i.e., type D patients] had a lower sense of coherence (p < 0.001), a lower quality of life (p < 0.001), more depressive symptoms (p < 0.001) and increased anxiety (p < 0.001) as compared to patients with a low type D score (Q1). During follow-up, type D patients (Q4) randomised to intervention had significant decrements in type D-score (p < 0.01), depression and anxiety (p < 0.05) and an increment in quality of life scores (p < 0.001). Quality of life was also improved in control type D patients (Q4; p < 0.01) but no significant changes were seen in type D score, depression or anxiety. Expanded cardiac rehabilitation reduces type D score, anxiety and depressive symptoms, and improves the quality of life in type D patients.
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Acknowledgments
The authors thank the research nurses Eva Cedergren, Anna Dahlback, Karin Jacobson, Inga-Märta Löhr, Ingela Stenmark, the medical social worker Ingela Sönne, the physiotherapists Susanne Gynning Ödlund and Lilli-Ann Thorén, the dietician Maria Gustafson, and the physicians Karin Hansson and Inge Björkander for skilful handling of the patients. This study was supported by grants from the Swedish Heart and Lung Foundation, The Swedish Heart- and Lung Association, The Stockholm County Council, Karolinska Institutet fund 176 and The Swedish Society of Medicine. The authors have no conflicts of interest to declare.
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Karlsson, M.R., Edström-Plüss, C., Held, C. et al. Effects of Expanded Cardiac Rehabilitation on Psychosocial Status in Coronary Artery Disease with Focus on Type D Characteristics. J Behav Med 30, 253–261 (2007). https://doi.org/10.1007/s10865-007-9096-5
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DOI: https://doi.org/10.1007/s10865-007-9096-5