OBJECTIVE: We aimed to investigate the prevalence of Type D personality (the 
conjoint effects of negative affectivity and social inhibition) among melanoma 
survivors and to obtain insight into its effects on health status, impact of 
cancer and health care utilisation.
METHODS: We selected all patients diagnosed with melanoma between 1998 and 2007 
from three large regional hospitals in the Netherlands. In total, 699 survivors, 
alive in January 2008, received a questionnaire including Type D personality 
scale (DS14), impact of cancer questionnaire (IOC) and SF-36 and 80% responded 
(n=562).
RESULTS: Twenty-two percent of survivors (n=125) were classified as Type D. They 
reported a clinically and statistically significant worse general health (57.8 
versus 75.6), social functioning (73.1 versus 88.7), mental health (61.7 versus 
80.6), more emotional role limitations (67.8 versus 89.4) and less vitality 
(54.5 versus 72.8) than non-Type D patients. Additionally, they reported a 
statistically and clinically relevant higher impact of cancer on body changes, 
negative self-evaluation, negative outlook on life, life interferences and 
health worry. Furthermore, they were more worried about the influence of the sun 
on their skin and acted accordingly. No differences were found in health care 
utilisation.
CONCLUSIONS: Type D personality has a distinct negative impact on health status 
in melanoma survivors and is an important factor to screen for in clinical 
practice. Giving special attention to these patients is important while they are 
more likely to experience a strong impact of cancer which cannot be explained by 
socio-demographical or clinical characteristics.