Female Psychological Adjustment Following an Acute Coronary Syndrome

Joana Prata, Amadeu Quelhas Martins, Sónia Ramos, Francisco Rocha-Gonçalves, Rui Coelho


Introduction: The outcomes of cardiovascular disease are consistently worse among women, regardless of age or disease severity. Such trend might arise from psychosocial factors, which should be examined in this population.
Objective: To evaluate the influence of type-D personality on anxiety and depression symptoms reported by female patients after a first acute coronary syndrome.
Material and Methods: As part of a larger study, 34 female patients with a first acute coronary syndrome were compared with 43 controls on psychosocial measures (Hospital Anxiety and Depression Scale; type-D personality, DS - 14).
Results: Hypertension (p < 0.001), diabetes (p < 0.05), dyslipidemia (p < 0.05), type-D personality (p = 0.001) and anxiety (p < 0.001) were more prevalent among patients. Exercise (p < 0.05) and antidepressant use (p < 0.05) were more common among controls. Logistic regression analysis confirmed that higher prevalence of hypertension (p < 0.05), dyslipidemia (p < 0.05), type-D personality (p < 0.05), anxiety (p < 0.05) and less antidepressant use (p < 0.05), were independently associated with acute coronary syndrome. Type-D personality was associated with higher Hospital Anxiety and Depression Scale scores in controls (anxiety: p = 0.001; depression: p < 0.001) but not in patients.
Discussion: High anxiety after an acute coronary syndrome might reflect a short-term adaptive response, albeit worsening the disease long-term prognosis. The lack of differences in some group comparisons (patients versus controls for depression scores; type-D ‘positive’ versus type-D ‘negative’ for anxiety and depression scores within patients) is discussed.
Conclusion: Type-D personality, high anxiety, hypertension and dyslipidemia seem to cluster among female acute coronary syndrome patients. Nevertheless, type-D personality itself was not associated with higher anxiety and depressive scores during the post-acute period.


Acute Coronary Syndrome/psychology; Adaptation, Psychological; Anxiety Disorders; Depressive Disorder; Female

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