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

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.