Relationships Among Type D Personality, Symptoms, Depression and Anxiety, and Quality of Life in Patients With Gastroesophageal Reflux Disease

BACKGROUND: Patients with gastroesophageal reflux disease (GERD) often experience typical or atypical symptoms accompanied by depression, anxiety, and low quality of life (QoL). In patients with various diseases, having a Type D personality has been linked to an elevated risk of developing symptoms such as depression and anxiety, as well as reduced QoL. PURPOSE: The objectives of this study were to examine the influence of Type D personality on GERD symptoms, depression and anxiety, and QoL and to identify the causal relationships among the variables influencing QoL in patients with GERD. METHODS: A cross-sectional correlational design and convenience sampling were used, and 149 patients with GERD were enrolled as study participants from the gastroenterology outpatient clinic of a university hospital in the Republic of Korea. Data were collected using structured questionnaires and tested using SPSS 28.0 and Amos 23.0. RESULTS: Approximately 46% of the participants met the criteria for inclusion in the Type D personality group. This group exhibited higher levels of depression and anxiety and diminished QoL than the non-Type D personality group. In the multiple regression model, GERD symptoms, depression and Type D personality were found to have a significant influence on QoL. In the structural equation model, GERD symptoms, depression, and Type D personality were shown to affect QoL, explaining 51.7% of the total variance in QoL. Two factors, namely depression and GERD symptoms, were identified as mediators of the association between Type D personality and QoL. CONCLUSIONS: The results of this study indicate a relatively high frequency of Type D personality among patients with GERD. When assessing QoL in patients with GERD, it is essential to consider the influence of Type D personality in conjunction with symptom experience and the presence of depression and anxiety. In particular, managing depression and symptoms in patients with GERD and a Type D personality may offer an effective approach to improving QoL in this patient group.