Abstract 1385: Prevalence of Anxiety and Type D Personality in an Outpatient ICD Clinic
Background: ICD patients can exhibit significant psychosocial stress including anxiety. Type D personality, characterized by negative emotions and social inhibition, has been shown to negatively impact perceived quality of life and have an adverse effect in cardiovascular illnesses. We sought to measure the incidence of type D personality and the prevalence of overall anxiety in an ambulatory ICD population.
Methods: To date 178 patients have been enrolled in a prospective study of anxiety in ICD patients, recruiting in the ICD device clinic at the Cleveland Clinic. Patients are enrolled at least 4 weeks after implantation of an ICD, seen in routine follow up, and administered the DS14 Type D questionnaire, from which the individual constructs of Negative Affectivity (NA) and Social Inhibition (SI) are also scored. The Beck Anxiety Inventory (BAI) was also administered, with total scores of 0 –9 correlating with no or low anxiety, 10 –18 mild to mod anxiety, 19 –29 mod-severe, and 30 – 63 severe anxiety. SPSS statistical software was used to calculate the collected data and interactions.
Results: This outpatient population consisted of 74% males with a prevalence of 18 % type D that was equally distributed among gender. The mean BAI score was 7.1; 73% scored with no to low anxiety. Female patients had higher BAI anxiety scores (10.7 vs 5.8) compared to males (p<0.001). Patients with Type D personality had higher anxiety scores (BAI 5.7 vs 13.8 BAI, p<0.001) with NA contributing to elevation of anxiety more so then SI (Pearson coefficient .636 vs .290).
Conclusions: In our ambulatory ICD population, overall anxiety rates were surprisingly low. The presence of Type D personality is a risk factor for increased anxiety. Screening for Type D personality may assist detecting at risk psychosocial ICD patients. Outcome studies of this patient population, including time from implantation and incidence of firings, warrant further study for quantification of overall ICD quality of life.