THE ROLE OF OBJECTIVE HEALTH INDICATORS AND NEUROTICISM IN PERCEIVED HEALTH AND PSYCHOLOGICAL WELL-BEING AMONG PATIENTS WITH CHRONIC HEART-FAILURE

A total of 119 clinically stable patients with symptomatic congestive heart failure (34 females, 85 males) were recruited from an outpatient hospital practice to explore the role of objective health indicators and neuroticism in subjective health (physical limitations) and psycho logical well-being. Patients were grouped according to the New York He art Association functional class criteria (NYHA: indicator of function al status) and proatrial natriuretic factor (proANF), a cardiac hormon e that maintains normal fluid balance and vascular resistance. Scores on these two objective indicators of disease severity were generally u nrelated to psychological measures, whereas neuroticism scores (EPQ-N) were significantly correlated with indicators of subjective health (p erceived disease-related physical limitations) and psychological well- being (depression, general life-satisfaction). Significant interaction s between proANF and neuroticism appear due to low physical limitation score among subjects with elevated level of proANF and low scores on neuroticism. High physical limitation was reported by subjects with hi gh level of proANF as well as high scores on neuroticism. Moreover, a marginal significant interaction between NYHA and EPQ-N scores in rela tion to severity of depression was detected by analyses from two-way A NOVA. Gender differences were due to higher proANF scores in males tha n females, whereas females scored higher than males on EPQ-N, perceive d physical limitation and depression. Results from path analyses suppo rted an indirect effect of neuroticism via perceived physical limitati on for males. Possible mechanisms involved in these relations are disc ussed. (C) 1997 Elsevier Science Ltd.