Association of Type D personality with increased vulnerability to depression: Is there a role for inflammation or endothelial dysfunction? - The Maastricht Study.

Abstract

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 (DS14), 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-α) and endothelial dysfunction (sVCAM-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 (β=0.228, p=0.014) and endothelial dysfunction (β=0.216, p=0.022). After adjustment for these biomarkers, Type D remained independently associated with increased vulnerability to depressive disorder (OR=13.20, p<0.001) and depressive symptoms (β=3.87, p<0.001).

LIMITATIONS:

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.

• Authors: Fleur E P van Dooren, Frans R J Verhey, Frans Pouwer, Casper G Schalkwijk, Simone J S Sep, Coen D A Stehouwer, Ronald M A Henry, Pieter C Dagnelie, Nicolaas C Schaper, Carla J H van der Kallen, Annemarie Koster, Miranda T Schram, Johan Denollet
• Journal: Journal of affective disorders (J Affect Disord) Vol. 189 Pg. 118-25 (Jan 01 2016) ISSN: 1573-2517 [Electronic] Netherlands
• PMID: 26433759 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier B.V. All rights reserved.

Chemical References

• Biomarkers
• Inflammation Mediators

Topics

• Adult
• Aged
• Biomarkers (blood)
• Cross-Sectional Studies
• Depression (pathology, psychology)
• Endothelial Cells (pathology)
• Female
• Humans
• Inflammation (blood, pathology)
• Inflammation Mediators (blood)
• Male
• Middle Aged
• Personality Assessment
• Prevalence
• Type D Personality