The Impact of Personality Traits on Health Status of Patients with Chronic Obstructive Pulmonary Disease in Primary and Secondary Care in the Netherlands H.J. Alma, MSc; C. de Jong, PhD; D.M. Joustra, BSc; J.W.H. Kocks, MD, PhD; Prof. T. Van der Molen, MD, PhD Presented by Harma Alma, MD-PhD Student IPCRG 27th of May 2016

Statement I have no conflict of interest to declare

Background (1) COPD is the 3rd leading cause of death Health status is an important goal in its management Various factors may influence health status scores Particular personality traits might be associated Definition personality: “the characteristics of a person that account for consistent patterns of feeling, thinking and behavior” Dubayova, 2009; GOLD, 2016; Lozano, 2012; Pervin, 2005; Samartzis, 2014; Sanderman, 2012

Background (2) Personality traits: Neuroticism: frustrations, worries, anxiety Extraversion: affinity to be talkative, optimistic, outgoing, energetic Psychoticism: aggressiveness, impulsiveness, egocentrism, being manipulative Evidence found in research for other diseases e.g. Parkinson, CHF, Cancer, MS Recently COPD Assessment Test (CAT) was related to personality and mental symptoms Aim: To investigate the relation of personality traits with health status of patients with COPD Aarstad, 2011; Beisland, 2013; Dubayova, 2009; Eysenck, 1994; Samartzis, 2014; Topp, 2016; Zarbo, 2015

Methods Ongoing longitudinal study: COPD patients in primary and secondary care (NL) Inclusion criteria: ≥40 years with diagnosis COPD GOLD I-IV Exclusion criteria: asthma overlap and/or other respiratory co-morbidities alpha 1 antitrypsin deficiency inability to read Dutch questionnaires Recruited September 2015-January 2016 Clinical COPD Questionnaire (CCQ), COPD Assessment Test (CAT), St. George Respiratory Questionnaire (SGRQ), Spirometry Eysenck Personality Questionnaire (EPQ-RSS) 48 Yes/No items Traits Neuroticism, Psychoticism, Extraversion – score 0-12 Jones, 1991; Jones, 2009; Sanderman, 2012; Van der Molen 2003

Patients (N=175) Table 1: Baseline characteristics Age (years) 47-84   Age (years) 47-84 Gender (% male) 60 GOLD I (%) 17 GOLD II (%) 37 GOLD III (%) 33 GOLD IV (%) 13 Smoking pack years 38 CCQ (mean±SD) 2.16 ± 1.04 CAT (mean±SD) 18.29 ± 7.12 SGRQ (mean±SD) 43.71 ± 19.45

Relevant correlations TABLE 2   Psychoticism Extraversion Neuroticism CCQ total -0.05 -0.19* +0.37* CCQ symptoms -0.06 -0.15* +0.18* CCQ functional status -0.03 +0.35* CCQ mental -0.12 +0.50* CAT -0.21* +0.36* SGRQ total -0.04 -0.23* +0.40* SGRQ symptoms -0.07 -0.18* +0.26* SGRQ activities +0.27* SGRQ impact -0.02 +0.45*

Conclusions Weak to moderate correlations between neuroticism and CCQ, CAT and SGRQ (mental/impact domains) Higher neuroticism scores  worse health status scores Significant, but weak negative correlations between extraversion and CCQ, CAT and SGRQ No significant correlations for psychoticism Certain personality traits seem to have weak to moderate relation with health status scores of patients with COPD Take individual personality (neuroticism) into account during COPD management

Questions? Thank you for your attention! E-mail: h.j.alma@umcg.nl

References Aarstad Anne K H AK. Distress, quality of life, neuroticism and psychological coping are related in head and neck cancer patients during follow-up. Acta Oncol. 2011-4;50(3):390-8. Beisland E, Aarstad AK, Osthus AA, Aarstad HJ. Stability of distress and health-related quality of life as well as relation to neuroticism, coping and TNM stage in head and neck cancer patients during follow-up. Acta Otolaryngol. 2013 Feb;133(2):209-17. Dubayova Tatiana T. Neuroticism and extraversion in association with quality of life in patients with Parkinson's disease. Quality of Life Research. 2009-2;18(1):33-42. Eysenck,H . J.,& Eysenck,S . B. G. (1994). Manual of the Eysenck Personality Inventory. London: University of London Press. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management and Prevention of COPD. 2016; Available at: www.goldcopd.nl. Accessed 15/1, 2016. Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline Leidy N. Development and first validation of the COPD Assessment Test. Eur Respir J 2009 Sep;34(3):648-654. Jones P W PW. The St George's Respiratory Questionnaire. Respir Med. 1991-9;85:25-31. Lozano Rafael R. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, The. 2012-12-15;380(9859):2095-128. Pervin LA, John OP, Cervone D (2005) Personality: theory and research, 9th edn. Wiley, New York. Samartzis Lampros L. Neuroticism personality trait is associated with Quality of Life in patients with Chronic Heart Failure. World Journal of Cardiology. 2014-10-26;6(10):1113-21. Sanderman, R., Arrindell, W. A., Ranchor, A. V.,Eysenck, H. J., & Eysenck, S. B. G. (2012). Het meten van persoonlijkheidskenmerken met de Eysenck Personality Questionnaire (EPQ), een handleiding. Tweede herziene druk. UMCG /Rijksuniversiteit Groningen, Research Institute SHARE. Topp M, Vestbo J, Mortensen EL. Personality Traits and Mental Symptoms are Associated with Impact of Chronic Obstructive Pulmonary Disease on Patients' Daily life. COPD. 2016 Apr 18:1-6. [Epub ahead of print] van der Molen T, Willemse BW, Schokker S, ten Hacken NH, Postma DS, Juniper EF. Development, validity and responsiveness of the Clinical COPD Questionnaire. Health Qual Life Outcomes. 2003 Apr 28;1:13. Zarbo Ignazio Roberto IR. Personality traits predict perceived health-related quality of life in persons with multiple sclerosis. Multiple Sclerosis Journal. 2015-7-10.