Fleur E P van Dooren1, Frans R J Verhey2, Frans Pouwer3, Casper G Schalkwijk4, Simone J S Sep4, Coen D A Stehouwer4, Ronald M A Henry4, Pieter C Dagnelie5, Nicolaas C Schaper6, Carla J H van der Kallen4, Annemarie Koster7, Miranda T Schram4, Johan Denollet8. 1. Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands; MHeNS - Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands. 2. MHeNS - Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands. 3. CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands. 4. Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands. 5. CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands; Department of Epidemiology, Maastricht University, Maastricht, the Netherlands. 6. Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands. 7. Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands. 8. CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands. Electronic address: J.Denollet@uvt.nl.
Abstract
BACKGROUND: Type D personality - the combination of negative affectivity (NA) and social inhibition (SI) - has been associated with depression but little is known about underlying mechanisms. We examined whether (1) Type D is a vulnerability factor for depression in general, (2) Type D is associated with inflammation or endothelial dysfunction, and (3) these biomarkers alter the possible association between Type D and depression. METHODS: In the Maastricht Study, 712 subjects underwent assessment of NA, SI and Type D personality (DS14), depressive disorder (Mini-International Neuropsychiatric Interview) and depressive symptoms (Patient Health Questionnaire-9). Plasma biomarkers of inflammation (hsCRP, SAA, sICAM-1, IL-6, IL-8, TNF-α) and endothelial dysfunction (sVCAM-1, sICAM-1, E-selectin, vWF) were measured with sandwich immunoassays or ELISA and combined into standardized sumscores. RESULTS: Regarding personality, 49% of the study population was low in NA and SI, 22% had SI only, 12% NA only and 17% had Type D. Depressive disorder and depressive symptoms were significantly more prevalent in Type D versus the other three personality subgroups. Multivariable regression analyses showed that Type D was associated with inflammation (β=0.228, p=0.014) and endothelial dysfunction (β=0.216, p=0.022). After adjustment for these biomarkers, Type D remained independently associated with increased vulnerability to depressive disorder (OR=13.20, p<0.001) and depressive symptoms (β=3.87, p<0.001). LIMITATIONS: The cross-sectional design restrained us to draw any conclusions on causality. The relatively low prevalence of depressive disorder restrained us to adjust for more potential confounders. CONCLUSIONS: Type D personality may be a vulnerability factor for depression, irrespective of levels of inflammation or endothelial dysfunction. Future research should examine possible underlying mechanisms.
BACKGROUND: Type D personality - the combination of negative affectivity (NA) and social inhibition (SI) - has been associated with depression but little is known about underlying mechanisms. We examined whether (1) Type D is a vulnerability factor for depression in general, (2) Type D is associated with inflammation or endothelial dysfunction, and (3) these biomarkers alter the possible association between Type D and depression. METHODS: In the Maastricht Study, 712 subjects underwent assessment of NA, SI and Type D personality (DS14), depressive disorder (Mini-International Neuropsychiatric Interview) and depressive symptoms (Patient Health Questionnaire-9). Plasma biomarkers of inflammation (hsCRP, SAA, sICAM-1, IL-6, IL-8, TNF-α) and endothelial dysfunction (sVCAM-1, sICAM-1, E-selectin, vWF) were measured with sandwich immunoassays or ELISA and combined into standardized sumscores. RESULTS: Regarding personality, 49% of the study population was low in NA and SI, 22% had SI only, 12% NA only and 17% had Type D. Depressive disorder and depressive symptoms were significantly more prevalent in Type D versus the other three personality subgroups. Multivariable regression analyses showed that Type D was associated with inflammation (β=0.228, p=0.014) and endothelial dysfunction (β=0.216, p=0.022). After adjustment for these biomarkers, Type D remained independently associated with increased vulnerability to depressive disorder (OR=13.20, p<0.001) and depressive symptoms (β=3.87, p<0.001). LIMITATIONS: The cross-sectional design restrained us to draw any conclusions on causality. The relatively low prevalence of depressive disorder restrained us to adjust for more potential confounders. CONCLUSIONS: Type D personality may be a vulnerability factor for depression, irrespective of levels of inflammation or endothelial dysfunction. Future research should examine possible underlying mechanisms.
Authors: Remy J H Martens; Ronald M A Henry; Alfons J H M Houben; Carla J H van der Kallen; Abraham A Kroon; Casper G Schalkwijk; Miranda T Schram; Simone J S Sep; Nicolaas C Schaper; Pieter C Dagnelie; Dennis M J Muris; Ed H B M Gronenschild; Frank M van der Sande; Karel M L Leunissen; Jeroen P Kooman; Coen D A Stehouwer Journal: J Am Soc Nephrol Date: 2016-05-09 Impact factor: 10.121
Authors: Johan S Bundgaard; Lauge Østergaard; Gunnar Gislason; Jens J Thune; Jens C Nielsen; Jens Haarbo; Lars Videbæk; Line L Olesen; Anna M Thøgersen; Christian Torp-Pedersen; Susanne S Pedersen; Lars Køber; Ulrik M Mogensen Journal: Qual Life Res Date: 2019-07-10 Impact factor: 4.147
Authors: Andrzej Witusik; Łukasz Mokros; Marcin Kosmalski; Michał Panek; Katarzyna Nowakowska-Domagała; Kasper Sipowicz; Piotr Kuna; Tadeusz Pietras Journal: Postepy Dermatol Alergol Date: 2018-08-21 Impact factor: 1.837