The effect of type D personality on quality of life, fatigue severity, and cardiovascular risk in patients with rheumatoid arthritis

Introduction The tendency to experience negative emotions, to supress self-expression and distressed personality patern are a features of type D personality (TDP) We aimed to evaluate the impact of TDP on cardiovascular disease (CVD), interstitial lung disease (ILD), disease activity, and general health in patients with rheumatoid arthritis (RA). Material and methods This cross-sectional study included 125 patients with RA. Sociodemographic data, laboratory parameters, disease activation parameters and interstitial lung disease involvement were recorded. We assessed the presence of TDP with a total of 14 items of the TDP Scale, the Framingham Risk Score (FRS) indicating the 10-year CVD risk as low, moderate and high, fatigue severity with the fatigue severity score and general health assessment with the12-Item Short-Form Health Survey (SF-12). Results Type D personality was not associated with lung involvement, cardiovascular risk (CVR), or disease activity. Patients with TDP reported significantly lower physical (d = 0.47, p = 0.012) and mental (d = 1.07, p < 0.001) health-related quality of life (SF-12 scores). Multiple linear regression analysis results indicated that negative affectivity was a significant predictor of SF-12 mental scores (B = –0.87, SE = 0.25,  = –0.72, p < 0.001) and explained 36.6% of the variance (R² = 0.366). The FRS was significantly elevated in RA patients with lung disease (8.0 vs. 2.0, d = 0.88, p < 0.001), and a higher proportion of these patients fell into the moderate and high CVR categories (compared to those without lung disease (d = 0.15, p < 0.001). Conclusions Neither lung involvement nor disease activity in RA patients is influenced by TDP trait. Patients with RA who have interstitial lung involvement have more chance of developing CVD. Type D personality, particularly negative affect, decreases overall health without affecting disease activity.