Increased anxiety and depression in Danish cardiac patients with a type D personality: cross-validation of the Type D Scale (DS14)

BACKGROUND: Type D personality is an emerging risk factor in cardiovascular disease. We examined the psychometric properties of the Danish version of the Type D Scale (DS14) and the impact of Type D on anxiety and depression in cardiac patients.

METHOD: Cardiac patients (n = 707) completed the DS14, the Hospital Anxiety and Depression Scale, and the Eysenck Personality Questionnaire. A subgroup (n = 318) also completed the DS14 at 3 or 12 weeks.

RESULTS: The two-factor structure of the DS14 was confirmed; the subscales negative affectivity and social inhibition were shown to be valid, internally consistent (Cronbach's alpha = 0.87/0.91; mean inter-item correlations = 0.49/0.59), and stable over 3 and 12 weeks (r = 0.85/0.78; 0.83/0.79; ps < 0.01). Type D was an independent associate of anxiety (beta, 0.49; p < 0.01) and depression (beta, 0.47; p < 0.01) in univariable linear regression analysis and remained a significant independent associate of anxiety (beta, 0.26; p < 0.01) and depression (beta, 0.17; p < 0.01) in adjusted analyses.

CONCLUSIONS: The Danish DS14 was shown to be a valid and reliable measure associated with increased symptoms of anxiety and depression independent of socio-demographic and clinical risk factors. The DS14 may be used in research and clinical practice to identify high-risk patients.