Beyond Type D personality: reduced positive affect (anhedonia) predicts impaired health status in chronic heart failure

OBJECTIVE: Type D personality has been associated with impaired health status in chronic heart failure (CHF), but other psychological factors may also be important. AIM: To determine whether non-Type D patients with low positive affect and Type D patients report lower health status, compared with non-Type D patients with high positive affect at 12-month follow-up in chronic heart failure. METHODS: Consecutive CHF outpatients (n = 276) filled out the Short Form-12 (health status) and Health Complaints Scale (disease-specific complaints) at inclusion and 12-month follow-up, and the DS14 (Type D personality) and positive affect (Global Mood Scale) at inclusion. Three groups were composed: non-Type D patients without anhedonia, non-Type D patients with anhedonia, and Type D patients. RESULTS: After controlling for demographic and clinical confounders, and scores at inclusion, anhedonic non-Type D patients reported lower mental health status (β = –.19, P < .004), and more feelings of disability (β = .10, P = .04), marginally lower physical health status (β = −.11, P = .07), and equal levels of cardiac symptoms (β = .04, P = .43), when compared with non-Type D’s without anhedonia. Type D patients reported lower levels of impaired mental health status, more cardiac symptoms and feelings of disability (−.31 < β < .17, all Ps < .05). A trend was shown for physical health status (β = −.11, P = .09). CONCLUSION: Non-Type D patients low on positive affect and Type D patients report lower levels of health status in CHF, compared with non-Type D patients with high positive affect. Future studies need to determine whether lack of positive affect is associated with impaired clinical outcome.