Association of personality type D and depression level with coping strategies in patients with chronic coronary syndrome

Abstract

Objective. To study associations of personality type D and depression level with coping strategies for coping with stress in patients with coronary heart disease (CHD). Design and methods. The study included 112 patients (68 men and 45 women), aged 25 to 81 years, who were admitted for elective percutaneous coronary intervention at the Research Institute for Complex Issues of Cardiovascular Diseases. To determine the type of personality D, the DS-14 questionnaire was used. To determine the level of anxiety and depression, the hospital scale HADS (Hospital Anxiety and Depression Scale) was used. To evaluate coping strategies, the questionnaires “Ways of Coping Behavior” (WCQ) and “Indicator of Coping Strategies” (The Coping Strategy Indication, CSI) were used. The patients were divided into groups in two variants: 1) with the presence or absence of personality type D and 2) with the presence of subclinical or clinical depression and its absence. Results. The presence of personality type D was detected in 35,4 % of patients, absence — in 64,6 % of patients. The presence of depression was detected in 25,5 % of patients, the absence of depression — in 74,5 % of patients. Patients with type no-D were more likely to use rare “Self-control” strategies (p = 0,04) and “Escape-avoidance” compared to type D (p = 0,05). Patients with depression more often used the strategies of “Problem resolution” (43 % and 11 %, p = 0,020), “Search for social support” (43 % and 5 %, p = 0,001) and “Avoidance” (21 % and 2 %, p = 0,012), rarely used “Confrontational coping” (36 % vs. 9 %, p = 0,001), without depression — moderate use of this strategy (66 % vs. 43 %, p = 0,033). The independent factors associated with type D were the level of anxiety (p = 0,022), the presence of depression (p = 0,044) and a moderate preference for the coping strategy “Taking responsibility” (p = 0,019). The binary logistic regression model was statistically significant (χ2(3) = 19,3, p < 0,001). Independent factors associated with depression were the level of negative excitability (p = 0,001) and the rare use of the “Confrontational coping” strategy (p = 0,001). The binary logistic regression model was statistically significant (χ2(2) = 21,9, p < 0,001). Conclusions. In patients with CHD with depression, the predominance of coping strategies was found: “Social support search strategy”, “Avoidance Strategy”, “Problem resolution Strategy” and, less often, “Confrontational coping”. With personality type D, the coping strategy “Self-control” was used less often and the “Escape-avoidance” strategy was used more often.