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 psychological well-being. Patients were grouped according to the New York Heart Association functional class criteria (NYHA: indicator of functional status) and proatrial natriuretic factor (proANF), a cardiac hormone that maintains normal fluid balance and vascular resistance. Scores on these two objective indicators of disease severity were generally unrelated to psychological measures, whereas neuroticism scores (EPQ-N) were significantly correlated with indicators of subjective health (perceived disease-related physical limitations) and psychological well-being (depression, general life-satisfaction). Significant interactions 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 high level of proANF as well as high scores on neuroticism. Moreover, a marginal significant interaction between NYHA and EPQ-N scores in relation to severity of depression was detected by analyses from two-way ANOVA. Gender differences were due to higher proANF scores in males than females, whereas females scored higher than males on EPQ-N, perceived physical limitation and depression. Results from path analyses supported an indirect effect of neuroticism via perceived physical limitation for males. Possible mechanisms involved in these relations are discussed.