Type D personality and social inhibition: drivers of cardiovascular risk and reduced physical activity in psoriatic arthritis

Abstract

Background: To evaluate the presence of type D personality and its association with metabolic syndrome (MetS), cardiovascular disease risk, and level of exercise in patients with psoriatic arthritis (PsA).

Material and method: This cross-sectional study included patients with PsA (n = 84) and healthy controls (n = 74). Sociodemographic data, laboratory parameters, and disease-related parameters were recorded. We evaluated the presence of type D personality with the total 14 items of the type D Personality Scale, the Framingham Risk Score (FRS) indicating 10-year cardiovascular disease risk as low, moderate, and high, the presence of MetS, and physical activity levels by the International Physical Activity Questionnaire-Short Form (IPAQ-SF).

Results: The median age of patients with PsA was 53.5 (17) years, 73.8% were female, and the disease duration was 7 (12) years. Compared to controls, patients with PsA exhibited higher FRS and increased frequency of MetS, type D personality, and its domains (social inhibition and negative affectivity) (p < 0.05 for all). Patients with type D personality had even a higher frequency of MetS and lower levels of moderate-intensity exercise than those without type D personality (p = 0.020 and p = 0.027). Patients with social inhibition had higher FRS, a higher frequency of MetS, and lower levels of moderate-intensity exercise (p < 0.05 for all) compared to those without social inhibition. MetS showed a significant positive correlation with social inhibition, waist circumference, and FRS (Spearman's rho were 0.244, 0.444, and 0.555, respectively), and a negative correlation with IPAQ-SF total metabolic equivalent (Spearman's rho was -0.214).

Conclusion: Patients with type D personality and social inhibition had a higher frequency of MetS and low levels of moderate-intensity exercise, whereas patients with social inhibition had a higher FRS. It is essential to assess PsA patients' cardiac risk factors, type D personality, and social inhibition, as well as provide exercise advice. Key Points •Psoriatic arthritis (PsA) is a prevelant rheumatologic disease that is frequently accompanied by comorbidities such as metabolic syndrome (MetS) and cardiovascular disease (CVD). •It is crucial to evaluate patients with PsA for CVD risk factors. •Patients with type D personality demonstrate lower engagement in moderate-intensity exercise and a higher frequency of MetS. Socially inhibited PsA patients showed elevated Framingham Risk Scores and MetS rates, as well as reduced levels of moderate-intensity exercise. •Beyond assessing cardiac risk factors, it is important to assess personality traits and offer tailored exercise recommendations for comprehensive PsA management.

Keywords: Framingham risk score; Metabolic syndrome; Psoriatic arthritis; Type D personality.