Anxiety and depression in patients with an implantable cardioverter defibrillator: Do personality and ICD expectations play a role?

Objective: To examine if Type D personality and expectations towards implantable cardioverter defibrillator (ICD) therapy are associated with symptoms of anxiety and depression in ICD patients one year after ICD implantation. Methods: Secondary analysis of first-time ICD patients from the national Danish ACQUIRE-ICD trial. Multiple linear regression analyses were conducted, adjusting for baseline outcome scores and potential confounders. Results: Of the 478 patients in the study, the mean age was 59.6 ± 11.6 and the majority were male (n = 397; 83.1 %). 73 patients (15.3 %) had a Type D personality. Baseline mean scores on positive expectations towards ICD implantation were 12.8 ± 3.18 and mean scores on negative expectations were 5.37 ± 3.30. Patients were followed up after one year with 352 (73.6 %) patients providing complete follow-up data. Type D personality was independently associated with 12 months depression scores (B = 2.44, 95 % CI [1.34, 3.55], p < .001) and 12 months anxiety scores (B = 1.92, 95 % CI [1.02, 2.82], p < .001), over and above initial distress levels. Neither positive nor negative ICD expectations were significantly associated with anxiety or depression at 12 months follow-up. Conclusion: Type D personality was predictive of increased anxiety and depression symptoms from ICD implantation to one-year follow-up. No significant association was found for ICD expectations.