Type D Personality Is Associated with Poorer Quality of Life in Patients with Chronic Spontaneous Urticaria: A Cross-sectional Study


  • Manuel Sánchez-Díaz Dermatology Unit, Hospital Universitario Virgen de las Nieves, Granada
  • Maria-Carmen Salazar-Nievas Urticaria Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada
  • Alejandro Molina-Leyva Dermatology Department, Hospital Universitario Virgen de las Nieves, Avenida de las Fuerzas Armadas 2, ES-18014 Granada, Spain
  • Salvador Arias-Santiago Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain




Urticaria, Quality of life, Type D personality


Type D personality (TDp) is a stable personality type that has been associated with poor quality of life in the general population and in patients with a variety of diseases, such as cancer, cardiac diseases, and dermatological diseases (e.g. psoriasis). To date, the potential association between chronic spontaneous urticaria and TDp has not been studied. The aim of this study is to analyse the impact of TDp on patients with chronic spontaneous urticaria, regarding mood disturbances, quality of life, sexuality, and sleep disturbances. A cross-sectional study including 75 patients with chronic spontaneous urticaria was performed. Data on socio- demographic variables and disease activity, quality of life, sleep, sexual dysfunction, anxiety, depression and TDp were collected using validated questionnaires. TDp was present in 28% (21/75) of the patients. Although TDp was not related to worse disease control, the presence of anxiety and depression was higher in patients with TDp. Regarding quality of life, TDp was associated with poorer quality of life and higher frequency of sleep disturbances. Prevalence of TDp in patients with chronic spontaneous urticaria is similar to that in the general population. It is associated with mood status disturbances and worse quality of life regardless of disease severity, especially in the emotional and psychological domains. This group of patients could benefit from additional psychological support as a complement to their medical treatment.


Download data is not yet available.


Saini SS, Kaplan AP. Chronic spontaneous urticaria: the devil's itch. J Allergy Clin Immunol Pract 2018; 6: 1097-1106.

https://doi.org/10.1016/j.jaip.2018.04.013 DOI: https://doi.org/10.1016/j.jaip.2018.04.013

Hon KL, Leung AKC, Ng WGG, Loo SK. Chronic urticaria: an overview of treatment and recent patents. Recent Pat Inflamm Allergy Drug Discov 2019; 13: 27-37.

https://doi.org/10.2174/1872213X13666190328164931 DOI: https://doi.org/10.2174/1872213X13666190328164931

Itakura A, Tani Y, Kaneko N, Hide M. Impact of chronic urticaria on quality of life and work in Japan: results of a real-world study. J Dermatol 2018; 45: 963-970.

https://doi.org/10.1111/1346-8138.14502 DOI: https://doi.org/10.1111/1346-8138.14502

Ograczyk-Piotrowska A, Gerlicz-Kowalczuk Z, Pietrzak A, Zalewska-Janowska AM. Stress, itch and quality of life in chronic urticaria females. Postepy Dermatol Alergol 2018; 35: 156-160.

https://doi.org/10.5114/ada.2018.75237 DOI: https://doi.org/10.5114/ada.2018.75237

Choi G-S, Nam Y-H, Park C-S, Kim M-Y, Jo E-J, Park H-K, et al. Anxiety, depression, and stress in Korean patients with chronic urticaria. Korean J Intern Med 2020; 35: 1507-1516.

https://doi.org/10.3904/kjim.2019.320 DOI: https://doi.org/10.3904/kjim.2019.320

McLean KC. Stories of the young and the old: personal continuity and narrative identity. Dev Psychol 2008; 44: 254-264.

https://doi.org/10.1037/0012-1649.44.1.254 DOI: https://doi.org/10.1037/0012-1649.44.1.254

Chilicka K, Rogowska AM, Szyguła R, Adamczyk E. Association between satisfaction with life and personality types A and D in young women with acne vulgaris. Int J Environ Res Public Health 2020; 17: 8524.

https://doi.org/10.3390/ijerph17228524 DOI: https://doi.org/10.3390/ijerph17228524

Mahoney CB, Lea J, Schumann PL, Jillson IA. Turnover, burnout, and job satisfaction of certified registered nurse anesthetists in the United States: role of job characteristics and personality. AANA J 2020; 88: 39-48.

Friedman HS. The multiple linkages of personality and disease. Brain Behav Immun 2008; 22: 668-675.

https://doi.org/10.1016/j.bbi.2007.09.004 DOI: https://doi.org/10.1016/j.bbi.2007.09.004

Mols F, Denollet J. Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related problems. Health Qual Life Outcomes 2010; 8: 9.

https://doi.org/10.1186/1477-7525-8-9 DOI: https://doi.org/10.1186/1477-7525-8-9

Kim SR, Nho J-H, Kim HY, Ko E, Jung S, Kim I-Y, et al. Type-D personality and quality of life in patients with primary brain tumours. Eur J Cancer Care (Engl) 2021; 30: e13371.

https://doi.org/10.1111/ecc.13371 DOI: https://doi.org/10.1111/ecc.13371

Kim SR, Nho J-H, Nam J-H. Relationships among Type-D personality, symptoms and quality of life in patients with ovarian cancer receiving chemotherapy. J Psychosom Obstet Gynaecol 2018; 39: 289-296.

https://doi.org/10.1080/0167482X.2017.1372416 DOI: https://doi.org/10.1080/0167482X.2017.1372416

Kupper N, Denollet J. Type D Personality as a risk factor in coronary heart disease: a review of current evidence. Curr Cardiol Rep 2018; 20: 104.

https://doi.org/10.1007/s11886-018-1048-x DOI: https://doi.org/10.1007/s11886-018-1048-x

Barone S, Bacon SL, Campbell TS, Labrecque M, Ditto B, Lavoie KL. The association between anxiety sensitivity and atopy in adult asthmatics. J Behav Med 2008; 31: 331-339.

https://doi.org/10.1007/s10865-008-9164-5 DOI: https://doi.org/10.1007/s10865-008-9164-5

Molina-Leyva A, Caparros-delMoral I, Ruiz-Carrascosa JC, Naranjo-Sintes R, Jimenez-Moleon JJ. Elevated prevalence of Type D (distressed) personality in moderate to severe psoriasis is associated with mood status and quality of life impairment: a comparative pilot study. J Eur Acad Dermatol Venereol 2015; 29: 1710-1717.

https://doi.org/10.1111/jdv.12960 DOI: https://doi.org/10.1111/jdv.12960

Denollet J. DS14: standard assessment of negative affectivity, social inhibition, and type D personality. Psychosom Med 2005; 67: 89-97.

https://doi.org/10.1097/01.psy.0000149256.81953.49 DOI: https://doi.org/10.1097/01.psy.0000149256.81953.49

García-Díez I, Curto-Barredo L, Weller K, Pujol RM, Maurer M, Giménez-Arnau AM. Cross-cultural adaptation of the urticaria control test from German to Castilian Spanish. Actas Dermosifiliogr 2015; 106: 746-752. DOI: https://doi.org/10.1016/j.adengl.2015.09.007

https://doi.org/10.1016/j.ad.2015.05.009 DOI: https://doi.org/10.1016/j.ad.2015.05.009

Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI) - a simple practical measure for routine clinical use. Clin Exp Dermatol 1994; 19: 210-216.

https://doi.org/10.1111/j.1365-2230.1994.tb01167.x DOI: https://doi.org/10.1111/j.1365-2230.1994.tb01167.x

Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983; 67: 361-370.

https://doi.org/10.1111/j.1600-0447.1983.tb09716.x DOI: https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

Alcaraz S, Hidalgo MD, Godoy C, Fernandez E. Spanish validation of the type D personality scale (DS14). Behav Psychol Conduct 2018; 26: 195.

Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11: 319-326.

https://doi.org/10.1038/sj.ijir.3900472 DOI: https://doi.org/10.1038/sj.ijir.3900472

Isidori AM, Pozza C, Esposito K, Giugliano D, Morano S, Vignozzi L, et al. Development and validation of a 6-item version of the female sexual function index (FSFI) as a diagnostic tool for female sexual dysfunction. J Sex Med 2010; 7: 1139-1146.

https://doi.org/10.1111/j.1743-6109.2009.01635.x DOI: https://doi.org/10.1111/j.1743-6109.2009.01635.x

Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28: 193-213.

https://doi.org/10.1016/0165-1781(89)90047-4 DOI: https://doi.org/10.1016/0165-1781(89)90047-4

Cuenca-Barrales C, Molina-Leyva A. Risk factors of sexual dysfunction in patients with hidradenitis suppurativa: a cross-sectional study. Dermatology 2020; 236: 37-45.

https://doi.org/10.1159/000501905 DOI: https://doi.org/10.1159/000501905

Beutel ME, Wiltink J, Till Y, Wild PS, Münzel T, Ojeda FM, et al. Type D personality as a cardiovascular risk marker in the general population: results from the Gutenberg health study. Psychother Psychosom 2012; 81: 108-117.

https://doi.org/10.1159/000331776 DOI: https://doi.org/10.1159/000331776

Aguayo-Carreras P, Ruiz-Carrascosa JC, Ruiz-Villaverde R, Molina-Leyva A. Four years stability of type D personality in patients with moderate to severe psoriasis and its implications for psychological impairment. An Bras Dermatol 2021; 96: 558-564.

https://doi.org/10.1016/j.abd.2021.02.005 DOI: https://doi.org/10.1016/j.abd.2021.02.005

Aguayo-Carreras P, Ruiz-Carrascosa JC, Molina-Leyva A. Type D personality is associated with poor quality of life, social performance, and psychological impairment in patients with moderate to severe psoriasis: a cross-sectional study of 130 patients. Indian J Dermatol Venereol Leprol 2020; 86: 375-381.

https://doi.org/10.4103/ijdvl.IJDVL_114_19 DOI: https://doi.org/10.4103/ijdvl.IJDVL_114_19

Manoj MT, Joseph KA, Vijayaraghavan G. Type D personality and myocardial infarction: a case-control study. Indian J Psychol Med 2020; 42: 555-559.

https://doi.org/10.1177/0253717620941157 DOI: https://doi.org/10.1177/0253717620941157

Damian RI, Spengler M, Sutu A, Roberts BW. Sixteen going on sixty-six: a longitudinal study of personality stability and change across 50 years. J Pers Soc Psychol 2019; 117: 674-695.

https://doi.org/10.1037/pspp0000210 DOI: https://doi.org/10.1037/pspp0000210

Akram U, McCarty K, Akram A, Gardani M, Tan A, Villarreal D, et al. The relationship between Type D personality and insomnia. Sleep Heal 2018; 4: 360-363.

https://doi.org/10.1016/j.sleh.2018.04.005 DOI: https://doi.org/10.1016/j.sleh.2018.04.005

Basińska MA, Woźniewicz A. The relation between type D personality and the clinical condition of patients with psoriasis. Postepy Dermatol Alergol 2013; 30: 381-387.

https://doi.org/10.5114/pdia.2013.39437 DOI: https://doi.org/10.5114/pdia.2013.39437



How to Cite

Sánchez-Díaz, M., Salazar-Nievas, M.-C., Molina-Leyva, A., & Arias-Santiago, S. (2022). Type D Personality Is Associated with Poorer Quality of Life in Patients with Chronic Spontaneous Urticaria: A Cross-sectional Study. Acta Dermato-Venereologica, 102, adv00734. https://doi.org/10.2340/actadv.v102.676