AUTHOR=de Vroege Lars , de Heer Eric W. , van der Thiel Eva , van den Broek Krista C. , van Eck van der Sluijs Jonna F. , van der Feltz-Cornelis Christina M. 

TITLE=Type D Personality, Concomitant Depressive and Anxiety Disorders, and Treatment Outcomes in Somatic Symptom and Related Disorders: An Observational Longitudinal Cohort Study

JOURNAL=Frontiers in Psychiatry

VOLUME=10

YEAR=2019

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2019.00417

DOI=10.3389/fpsyt.2019.00417

ISSN=1664-0640

ABSTRACT=<p><bold>Objective:</bold> To establish the prevalence of Type D personality in patients with somatic symptoms and related disorders and to evaluate the association of Type D personality with treatment outcomes. This study explores the effect of Type D personality and its two traits, negative affectivity (NA) and social inhibition (SI).</p><p><bold>Methods:</bold> In this longitudinal observational cohort study, we assessed the prevalence of Type D in 212 patients presenting themselves at a clinic in Tilburg, the Netherlands. We explored psychological and physical treatment outcomes of a multimodal treatment tailored to patient needs in relation to Type D scores. We explored the differences with regard to physical symptoms, anxiety, and depression. We also explored the differences between patients with and without Type D personality who completed treatment with regard to the baseline scores of physical symptoms, anxiety, and depression. We explored the association between Type D personality and treatment outcome using the traditional dichotomous method and the dimensional method (with main effects of NA and SI, and the interaction of NA × SI).</p><p><bold>Results:</bold> Of the 212 patients with Somatic Symptom and Related Disorders (SSRD), those with Type D personality (181: 61.8%) had experienced significantly higher levels of depression [<italic>t</italic> = 4.404, <italic>p</italic> &lt; .001] and anxiety [<italic>t</italic> = 3.757, <italic>p</italic> &lt; .001]. Of the 212, 187 patients completed treatment. Mean scores improved significantly for the whole patient group after treatment with regard to depression (<italic>p</italic> &lt; .001), anxiety (<italic>p</italic> &lt; .001), and physical symptoms (<italic>p</italic> &lt; .001). At baseline, patients with Type D personality had significantly higher scores in anxiety [<italic>F</italic> = 15.707, <italic>p</italic> &lt; .001] and depression [<italic>F</italic> = 19.392] than patients without Type D personality who completed treatment. After controlling for the high baseline scores with regard to physical symptoms, anxiety, or depression, only the effect of Type D personality on remission of anxiety was significant (<italic>OR</italic> = .33, <italic>p</italic> = 0.39). Neither NA and SI nor the interaction of NA × SI was associated with the treatment outcome.</p><p><bold>Conclusions:</bold> This study shows that Type D personality occurs frequently in patients with SSRD. Type D personality only decreases the probability of remission of anxiety as a treatment outcome, and both NA and SI play a role in this. Type D personality did not decrease remission either of physical symptoms or of depression. Hence, both NA and SI factors may be expressions of anxiety mostly in type D.</p>