TY - JOUR
T1 - Association of Type D personality with increased vulnerability to depression: is there a role for inflammation or endothelial dysfunction? - the Maastricht Study
AU - van Dooren, Fleur
AU - Verhey, F.R.J.
AU - Pouwer, F.
AU - Schalkwijk, C.G.
AU - Sep, S.J.S.
AU - Stehouwer, C.D.A.
AU - Henry, R.M.A.
AU - Dagnelie, P.C.
AU - Schaper, N.C.
AU - van der Kallen, C.J.H.
AU - Koster, A.
AU - Schram, M.T.
AU - Denollet, J.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - 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 (D514), 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-alpha) and endothelial dysfunction (5VCAM-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 (beta=0.228, p =0.014) and endothelial dysfunction (beta=0.216, p =0.022). After adjustment for these biomarkers, Type D remained independently associated with increased vulnerability to depressive disorder (OR= 13.20, pLimitations: 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.
AB - 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 (D514), 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-alpha) and endothelial dysfunction (5VCAM-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 (beta=0.228, p =0.014) and endothelial dysfunction (beta=0.216, p =0.022). After adjustment for these biomarkers, Type D remained independently associated with increased vulnerability to depressive disorder (OR= 13.20, pLimitations: 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.
KW - Personality
KW - Depression
KW - Inflammation
KW - Endothelial dysfunction
KW - CORONARY-HEART-DISEASE
KW - NEGATIVE AFFECTIVITY
KW - SOCIAL INHIBITION
KW - TNF-ALPHA
KW - DSM-IV
KW - VALIDITY
KW - STRESS
KW - COMMUNITY
KW - METAANALYSIS
KW - OUTPATIENTS
U2 - 10.1016/j.jad.2015.09.028
DO - 10.1016/j.jad.2015.09.028
M3 - Article
C2 - 26433759
SN - 0165-0327
VL - 189
SP - 118
EP - 125
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -