Illness perception profiles and psychological and subjective physical symptoms in atrial fibrillation

Illness perceptions have been associated with outcomes in patients with atrial fibrillation (AF). This study aimed to identify distinct illness perception profiles in patients with AF and examine their associations with psychological and physical responses.

A total of 150 patients with AF were enrolled in this study. Illness perception profiles were identified using latent profile analysis (LPA). Model fit indices were evaluated to determine the optimal class solution. Logistic regression analyses were conducted to examine the associations between illness perception profiles and psychological and physical outcomes, including Generalized anxiety disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), 12-Item Short Form Health Survey (SF-12) and University of Toronto atrial fibrillation severity scale (AFSS).

A two-class model was identified as optimal, comprising a "Reactive-Minimizing" profile (Class 1, 49%) and a "Symptom-Helplessness" profile (Class 2, 51%). Univariate logistic analysis revealed significant differences between classes in age, AF type, work status, PHQ-9, AFSS-symptoms, and AFSS-burden. In the multivariable logistic regression adjusted for age and sex (logistic outcome: Class 2 vs. Class 1), higher AFSS-burden scores were independently associated with the "Symptom-Helplessness" profile (OR = 1.26, 95% CI: 1.09-1.45, p = 0.001). Conversely, higher PHQ-9 scores were associated with the "Reactive-Minimizing" profile (OR for Symptom-Helplessness = 0.92, 95% CI: 0.86-0.99, p = 0.018).

Person-centered illness perception profiling revealed two distinct cognitive-emotional patterns in patients with AF that were associated with depressive symptoms and symptom burden, highlighting their potential value for individualized psychological and clinical management.