Çarpıntı şikâyeti ile başvuran olgularda gizli kalmış ayrıntılar: D tip kişilik depresyon ve anksiyete

Öz

Amaç: Çarpıntı şikâyeti olan ve organik bir neden tespit edilemeyen hastalarda, D tipi kişiliğin oranı ve depresyon, anksiyete puanları bilinmemektedir. Bunların bilinmesi çarpıntının etiyolojisini anlamada ve tedavisinde katkı sağlayabilir.

Yöntemler: Kardiyoloji Polikliniğine çarpıntı şikayeti ile başvuran, çarpıntının olası organik etiyolojileri ekarte edilmiş olan ve 18 yaşından büyük hastalar araştırmaya dâhil edilmiştir. Çalışmada sosyodemografik veri formu, D Tipi Kişilik Ölçeği, Hastane Ansiyete ve Depresyon Ölçeği kullanıldı.

Bulgular: Depresyon puanları hasta grubunda yüksek bulundu (p<0.05). Hasta grubundakilerin %60’ında, kontrol grubunun %22’sinde D tipi kişilik tespit edildi. Hasta ve kontrol grubu olguların D tipi varlığı ile yaş, cinsiyet, medeni durum, depresyon ve anksiyete puanları ilişkisi için yapılan Spearman korelasyon analizi sonuçları incelendiğinde D tipi varlığı ile; Hasta grubunda eğitim durumu arasında negatif yönde, zayıf ve anlamlı ilişki bulundu (p<0,05). Hasta ve kontrol grubu olgularda D tipi varlığı ile depresyon ve anksiyete puanları arasında güçlü, pozitif yönde ve anlamlı ilişki bulundu (p<0,05).

Sonuç: Birçok kardiyolojik hastalıkta etkili olduğu bilinen D tipi kişiliğin ve depresyonun, çarpıntıda da fazla olduğunun bilinmesi palpitasyonun etiyolojisini anlamada ve tedavisini yapmada katkı sağlayabilir.

Anahtar Kelimeler

• Anksiyete,Depresyon,Çarpıntı,Tip D kişilik

Hidden details in cases with palpitation complaints: Type D personality depression and anxiety

Abstract

Aim: In patients with complaints of palpitation and where an organic cause cannot be determined, the rate of type D personality and depression and anxiety scores are unknown. Knowing these may contribute to the understanding and treatment of the etiology of the palpitation.

Methods: Patients who applied to Cardiology Polyclinic with palpitation complaint, whose possible organic etiologies of the palpitation were excluded and those over 18 years old were included in the study. Sociodemographic data form, Type D Personality Scale, Hospital Anxiety and Depression Scale were used in the study.

Results: Depression scores were higher in the patient group (p<0.05). When the mean distribution of anxiety scores were examined, no significant difference was found between the groups. D type personality was detected in 60% of the patient group and 22% of the control group. When the results of Spearman's correlation analysis made for the relationship between type D presence of patient and control group and age, gender, marital status, depression and anxiety scores were examined, there was a negative, weak and significant relationship between type D presence and educational status in the patient group (p<0.05). There was a strong positive correlation between type D presence and depression and anxiety scores in the patient and control group subjects (p<0.05).

Conclusions: Knowing that D Type Personality and depression which are proven to affect many cardiologic diseases are also frequent in palpitation may help better understanding and treatment of palpiatiton.

Keywords

• Anxiety,Depression,Palpitation,Type D personality

Kaynakça

1. 1. Denollet J, Sys SU, Brutsaert DL. Personality and mortality after myocardial infarction. Psychosom Med 1995;57(6):582-91.
2. 2. Denollet J. Type D personality. A potential risk factor defined. J Psychosom Res 2000;49(4):255–66.
3. 3. Schiffer AA, Pedersen SS, Widdershoven JW, Hendriks EH, Winter JB, Denollet J. The distressed (type D) personality is independently associated with impaired health status and increased depressive symptoms in chronic heart failure. Eur J Cardiovasc Prev Rehabil 2005;12(4):341-6.
4. 4. Pedersen SS, Denollet J. Is type D personality here to stay? Emerging evidence across cardiovascular disease patient guoups. Curr Cardiol Rev 2006;2(3):205–13.
5. 5. Doyle F, McGee HM, Conroy RM, Delaney M. What predicts depression in cardiac patients: sociodemographic factors, disease severity or theoretical vulnerabilities? Psychol Health 2011;26(5):619-34.
6. 6. Kroenke K, Arrington ME, Mangelsdorff AD. The prevalence of symptoms in medical outpatients and the adequacy of therapy. Arch Intern Med 1990;150(8):1685–9.
7. 7. Zimetbaum P, Josephson ME. Evaluation of patients with palpitations. N Engl J Med 1998;338(19):1369–73.
8. 8. Probst MA, Mower WR, Kanzaria HK, Hoffman JR, Buch EF, Sun BC. Analysis of Emergency Department Visits for Palpitations (from the National Hospital Ambulatory Medical Care Survey). Am J Cardiol 2014;15;113(10):1685-90.

9. 9. Denollet J. Personality and coronary heart disease:the type D scale 16(DS16). Ann Behav Med 1998;20(3):209-15.
10. 10. Grande G, Jordan J, Kummel M, Struwe C, Schubmann R, Schulze F, et al. Evaluation of the German Type D Scale (DS14) and prevalence of the Type D personality pattern in cardiological and psychosomatic patients and healty subjects. Psychother Psychosom Med Psychol 2004; 54(11):413-22.
11. 11. Pedersen SS, Denollet J. Validity of the Type D personality construct in Danish post-MI patients and healthy controls. J Psychosom Res 2004;57(3):265-72.
12. 12. ZigmondAS, Snaith PR. The hospital anxiety and depression scale. Acta Psychiatry Scand 1983;67(6):361-70.
13. 13. Aydemir Ö, Güvenir T, Küey L, Kültür S. Hastane Anksiyete ve Depresyon Ölçeği Türkçe formunun geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi 1997;8:280-87.
14. 14. Reich J, Schatzberg A. Personality traits and medical outcome of cardiac illness. J Psychiatr Res 2010;44(15):1017-20.
15. 15. Denollet J, Pedersen SS, Ong AT, Erdman RA, Serruys PW, von Damburg RT. Social inhibition modulates the effect of negative emotions on cardiac prognosis following percutaneous coronary intervention in the drug-eluting stent era. Eur Heart J 2006;27(2):171–7.
16. 16. Gross JJ, Levenson RW. Hiding feelings: the acute effects of inhibiting negative and positive emotion. J Abnorm Psychol 1997;106(1):95–103.
17. 17. Horsten M, Ericson M, Perski A, Wamala SP, Schenck-Gustafsson K, Orth-Gomer K. Psychosocial factors and heart rate variability in healthy women. Psychosom Med 1999;61(1):49–57.
18. 18. Andreassi JL. "The psychophysiology of cardiovascular reactivity." Int J Psychophysiol 1997;25(1):7-11.
19. 19. Pedersen SS, Denollet J. Type D personality, cardiac events, and impaired quality of life: review. Eur J Cardiovasc Prev Rehabil 2003;10(4):241-8.
20. 20. Conraads VM, Denollet J, De Clerck LS, Stevens WJ, Brisdts C, Vrints CJ. Type D personality is associated with increased levels of tumour necrosis factor (TNF)-alpha and TNF-alpha receptors in chronic heart failure.Int J Cardiol 2006;113(1):34-8.
21. 21. Denollet J, Schiffer AA., Kwaijtaal M, Hooijkaas H, Hendriks EH, Widdershoven J, et al. Usefulness of Type D personality and kidney dysfunction as predictors of interpatient variability in inflammatory activation in chronic heart failure. Am J Cardiol 2009;103(3):399-404.
22. 22. Granville Smith I, Parker E, Cvejic E, Vollmer-Conna U. Acute coronary syndrome-associated depression: the salience of a sickness response analogy? Brain Behav Immun 2015;49:18-24.
23. 23. Van Craenenbroeck EM, Denollet J, Paelinck BP, Beckers P, Possemiers N, Hoymans VY, et al. Circulating CD34+/KDR+ endothelial progenitor cells are reduced in chronic heart failure patients as a function of Type D personality. Clin Sci (Lond.) 2009;117(4):165-72.
24. 24. Denollet J, Schiffer AA, Spek V. A general propensity to psychological distress affects cardiovascular outcomes: evidence from research on the type D (distressed) personality profile. Circulation: cardiovascular quality and outcomes 2009;3(5): 546-57.
25. 25. Habra ME, Linden W, Anderson JC, Weinberg J. Type D personality is related to cardiovascular and neuroendocrine reactivity to acute stress. J Psychosom Res. 2003;55(3):235–45.
26. 26. Williams L, O'Carroll RE, O'Connor RC. Type D personality and cardiac output in response to stress. Psychol Health. 2009;24(5):489–500.
27. 27. van Dooren FE, Verhey FR, Pouwer F, Schalkwijk CG, Sep SJ, Stehouwer CD, et al. Association of Type D personality with increased vulnerability to depression: Is there a role for inflammation or endothelial dysfunction? The Maastricht Study. J Affective Disord 2016;189(1):118-25.
28. 28. Watson D, Pennebaker JW. Health complaints, stress, and distress: exploring the central role of negative affectivity. Psychological review 1989;96(2):234.
29. 29. Williams L, O'Connor RC, Grubb NR, O'Carroll RE. Type D personality and illness perceptions in myocardial infarction patients. J Psychosomatic Res 2011;70(2):141-4.