russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2020-3996russjcardiol-3996Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWКонцепция типа личности Д — это компонент в формировании персонифицированного подхода или прогностический фактор при лечении сердечно-сосудистых заболеваний?Is the concept of type D personality a component of personalized medicine or a prognostic factor in the treatment of cardiovascular diseases?https://orcid.org/0000-0002-0963-4793СуминА. Н.SuminA. N.

Сумин Алексей Николаевич — заведующий лабораторией коморбидности при сердечно-сосудистых заболеваниях отдела клинической кардиологии.

Кемерово.

Alexey N. Sumin - head of the laboratory of comorbidity in cardiovascular diseases, department of clinical cardiology.

Kemerovo.

an_sumin@mail.ruhttps://orcid.org/0000-0002-4108-164XЩегловаА. В.ShcheglovaA. V.

Щеглова Анна Викторовна — научный сотрудник лаборатории коморбидности при сердечно-сосудистых заболеваниях отдела клинической кардиологии.

Кемерово.

Anna V. Shcheglova - researcher at the laboratory of comorbidity in cardiovascular diseases, department of clinical cardiology.

Kemerovo.

nura.karpovitch@yandex.ruНаучно-исследовательский институт комплексных проблем сердечно-сосудистых заболеванийРоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian Federation20201707202025939963996Copyright © Сумин А.Н., Щеглова А.В., 20202020Сумин А.Н., Щеглова А.В.Sumin A.N., Shcheglova A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/3996

Изучение личностных особенностей пациента выглядит вполне обоснованным и актуальным при реализации пациент-ориентированных подходов в лечении кардиологических больных. Концепция типа личности Д (характеризуется сочетанием негативной возбудимости и социального подавления) представляется наиболее подходящей для таких целей. Тип личности Д относится к хроническим психосоциальным факторам риска, ассоциируется со снижением качества жизни пациентов, рекомендован для скрининга у больных. Дополнительный анализ показал гетерогенность влияния типа Д на прогноз в зависимости от стадии развития заболевания (ишемическая болезнь сердца или хроническая сердечная недостаточность), возраста, использованных конечных точек. Кроме того, этнические, географические и социально-экономические факторы, различия в менталитете народов также могут влиять на прогностическое значение типа личности Д, как показал ряд исследований в азиатских странах и России. Среди возможных механизмов влияния типа Д на прогноз выделяют малоадаптивные реакции на стресс, а также поведенческие особенности таких пациентов. В оценке “эффекта типа Д” в последнее время предлагается использовать дополнительные сложные расчеты с оценкой “аддиктивных” и “синергетических” эффектов двух его подшкал. Представляется, что в клинической практике и скрининговых исследованиях целесообразно использовать классический вариант оценки типа личности Д с помощью опросника DS-14. До сих пор вопрос о возможности влияния на лиц с типом личности Д остается неизученным. Перспективными выглядят следующие стратегии в лечении: коррекция избыточных реакций на стресс, а также воздействие на уровне неадекватных стратегий преодоления стресса. Конечной целью таких вмешательств должно быть не только улучшение психологического функционирования пациентов, но и замедление прогрессирования соматического заболевания и улучшение прогноза.

The study of a patient's personal traits is reasonable and relevant in the implementation of personalized medicine in cardiology. The use of type D personality concept seems suitable for such aims. Type D personality refers to chronic psychosocial risk factors, which associated with a decrease in the quality of life, and is recommended for screening. Additional analysis showed the heterogeneity of type D effect on prognosis depending on the stage of disease (coronary artery disease or heart failure), age, and endpoints used. In addition, ethnic, geographic and socio-economic factors, differences in the mentality can also affect the predictive value of type D personality. Possible mechanisms of its influence on the prognosis are maladaptive response to stress, as well as the behavioral characteristics of such patients. In assessing the type D effect, it has recently been proposed to use additional calculations with an estimate of the addictive and synergistic effects. In clinical practice and screening studies, conventional assessment of type D personality using the DS-14 questionnaire seems reasonable. Until now, the question of influencing persons with type D personality remains unstudied. The following treatment strategies look promising: change of excessive responses to stress; the influence on inadequate stress coping strategies. The ultimate goal of such interventions should be not only to improve the psychological functioning of patients, but also to slow down the progression of the physical illness and improve the prognosis.

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The authors declare that there are no conflicts of interest present.