Type A behaviour: a reappraisal of its characteristics in cardiovascular disease

Aims: The role of type A behaviour in cardiovascular disease is controversial andmost of the research is based on self-rating scales. The aim of this study was toassess the prevalence of type A behaviour in cardiology and in other medical set-tings using reliable interview methods that reflect its original description.Methods: A sample of 1398 consecutive medical patients (198 with heart trans-plantation, 153 with a myocardial infarction, 190 with functional gastrointestinaldisorders, 104 with cancer, 545 with skin disorders and 208 referred for psychiat-ric consultation) was administered the Structured Clinical Interview for the DSM-IVand the Structured Interview for the Diagnostic Criteria for Psychosomatic Research(DCPR) which identifies 12 clusters, including type A behaviour. Results: A cardiaccondition was present in 366 patients. There was a significant difference in theprevalence of type A behaviour in cardiovascular disease (36.1%) compared withother medical disorders (10.8%). Type A behaviour frequently occurred togetherwith psychiatric and psychosomatic disturbances, particularly irritable mood, eventhough in the majority of cases it was not associated with DSM diagnoses. Amongcardiac patients, those with type A behaviour were less depressed, demoralisedand worried about their illness. Conclusions: Type A behaviour was found tooccur in about a third of cases of patients with cardiovascular disease. Only in alimited number of cases was it associated with depression. It has a lifestyle conno-tation that may have important clinical consequences as to stress vulnerability andillness behaviour