Depressive Status in Patients With Chronic Thromboembolic Pulmonary Hypertension

Funabashi, Sayaka; Kataoka, Masaharu; Inami, Toru; Kikuchi, Toshiaki; Yanagisawa, Ryoji; Ishiguro, Chikako; Okamoto, Susumu; Yoshino, Hideaki; Watanabe, Koichiro; Satoh, Tsuyoshi

doi:10.1253/circj.cj-17-0197

Cited by 5 publications

(12 citation statements)

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“…For example, Suzuki et al reported that 7% of their patients with CTEPH had a diagnosis of schizophrenia, 20 as did 3.9% of our patients; both these figures are higher than the prevalence of schizophrenia in the general population 21 . Furthermore, Funabashi et al reported a higher frequency of depression in patients with CTEPH 22 . Our group has recently identified that a Jamieson classification of III or IV and a high PVR were associated with poor survival, although similar survival rates were recently observed in patients with CTEPH treated by BPA, PEA, and medication between 2009 and 2016 23 .…”

Section: Discussionsupporting

confidence: 41%

Clinical characteristics and prognosis in patients with chronic thromboembolic pulmonary hypertension and a concomitant psychiatric disorder

et al. 2019

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Chronic thromboembolic pulmonary hypertension (CTEPH) can cause right heart failure. A concomitant psychiatric disorder (PD) is thought to increase the risk of acute pulmonary thromboembolism; however, whether PDs are associated with deterioration in CTEPH pathophysiology is unclear. In this study, we evaluated the clinical characteristics and prognoses in patients with CTEPH and a co-existing PD. We retrospectively identified 229 consecutive patients (mean age = 58.7 ± 12.5 years; 160 women) with CTEPH and categorized them according to whether they had a PD (PD group; n = 22, 9.7%) or not (non-PD group; n = 207, 90.3%). We compared the clinical characteristics, respiratory function, hemodynamics, and clinical courses in the two groups. Those in the PD group had significantly lower exercise tolerance compared to the non-PD group (6-min walk test, 309.5 ± 89.5 m vs. 369.4 ± 97.9 m, P = 0.008, percent vital capacity 85.5% ± 17.3% vs. 96.0% ± 15.5%, P = 0.003) and partial pressure of oxygen (PaO2) (54.4 ± 8.6 mmHg vs. 59.3 ± 10.7 mmHg, P = 0.039). Three-year survival was significantly poorer in the PD group compared to the non-PD group (66.1% vs 89.7%, P = 0.0026, log-rank test), particularly in patients who underwent surgery (62.2% vs 89.5%, P < 0.001, log-rank test). A concomitant PD was associated with low exercise tolerance and impaired respiratory function in patients with CTEPH and predicted poor survival, especially in those who underwent a pulmonary endarterectomy.

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Section: Discussionsupporting

confidence: 41%

Clinical characteristics and prognosis in patients with chronic thromboembolic pulmonary hypertension and a concomitant psychiatric disorder

et al. 2019

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“…Other factors being possibly associated with worse quality of life include higher clot burden at index PE event, abnormal NT-proBNP at index PE event, persistent right ventricular dysfunction, as well as non-VTE comorbidities such as COPD obesity and cancer (8,55,59,(63)(64)(65)(66)(67)(68)(69)(70). As it may be expected, the association between CTEPH and poor quality of life has been unequivocally established (71)(72)(73)(74).…”

Section: Impact Of Cteph and The Post-pe Syndromementioning

confidence: 97%

Follow-up after acute Pulmonary Embolism

Klok¹

2018

Hamostaseologie

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SummaryIn addition to among others major bleeding from anticoagulant therapy and recurrent venous thromboembolism (VTE), patients who survived acute pulmonary embolism (PE) face an increased risk of chronic functional limitations and decreased quality of life. In recent years, this latter complications have been better framed within the evolving definition of “post-PE syndrome” of which chronic thromboembolic pulmonary hypertension (CTEPH) represents the most extreme presentation. The post-PE syndrome in all its aspects is a frequent and clinically relevant long-term complication of PE but -except for CTEPH- has been largely understudied. There is great need to better define and understand the natural course of acute PE, to predict the development of the post-PE syndrome and to evaluate the potential benefits evolving treatments such as cardiopulmonary rehabilitation.

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“…16 Funabashi et al reported that 37.5% of CTEPH patients in their study had depression and that CTEPH patients were significantly more depressed than healthy individuals (37.5% vs 8.9%). 17 A study conducted by Pfeuffer et al compared PAH and CTEPH patients, reporting that the rate of depression was higher among those with CTEPH than those with PAH (56% vs 30%; p=0.03). 18 We found only one mixed-method study on PH patients and their symptom distress: in a study conducted by Muntingh et al of 67 PAH patients, participants reported low and fluctuating energy levels, difficulty with loss of abilities, worries about the future, restricted ability to fulfil their roles, and being misunderstood by others.…”

Section: Open Accessmentioning

confidence: 99%

“…This finding was similar to the findings of prior research. [12][13][14][15][16][17][18] This suggests, that despite dramatic advances in treatment methods that have improved life expectancy, mental health has not improved. To better understand these results, we conducted qualitative interviews with participants who had depressive symptoms.…”

Section: Integration Of the Quantitative And Qualitative Datamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Depression, anxiety and psychological distress in patients with pulmonary hypertension: a mixed-methods study

et al. 2021

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IntroductionPulmonary hypertension (PH) is a chronic and progressive disease. While prognoses have improved, PH patients still experience side effects and activity restrictions. Accordingly, the key questions asked by this study are ‘How many PH patients have depression/anxiety symptoms?’ and ‘Is there a difference in the symptoms and distress factors between pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH) patients, and how are they experiencing distress?’MethodsA mixed-methods study was conducted to collect and analyse quantitative and qualitative data. We administered questionnaires (Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder-7) and then conducted interviews with participants who reported moderate to severe depressive symptoms (PHQ-9 ≥10).ResultsSeventy-four participants were enrolled in the study, 25 with idiopathic PAH and 49 with CTEPH. Their average age was 55.2 years (PAH 42.7 years, CTEPH 61.5 years). Overall, 44.6% of participants had mild or more severe depressive symptoms (PHQ-9 ≥5) and 17.6% had moderate or more severe depressive symptoms (PHQ-9 ≥10). PAH patients had particularly high depressive symptoms (PHQ-9 ≥5: PAH 64.0%, CTEPH 34.7%; PHQ-9 ≥10: PAH 24%, CTEPH 14.3%). We extracted four common themes from the qualitative interview data on participants’ experience of psychological distress: ‘Loss of myself,’ ‘Isolation from my surroundings,’ ‘Hassle associated with oxygen therapy,’ and ‘Fear of illness progression/deterioration.’ One theme— ‘Suffering from side effects’—was extracted only for PAH patients, while another—‘Rumination on illness due to breathlessness’—was extracted only for CTEPH patients.Discussion and conclusionThe study found that PH patients are prone to depression. The identification of factors and themes that influence the psychological distress of PH patients is important information that can be used to improve the support for the physical and mental health of these patients. Interventions for these distress may contribute to improving the mental status of PH patients.

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Depressive Status in Patients With Chronic Thromboembolic Pulmonary Hypertension

Cited by 5 publications

References 11 publications

Clinical characteristics and prognosis in patients with chronic thromboembolic pulmonary hypertension and a concomitant psychiatric disorder

Clinical characteristics and prognosis in patients with chronic thromboembolic pulmonary hypertension and a concomitant psychiatric disorder

Follow-up after acute Pulmonary Embolism

Depression, anxiety and psychological distress in patients with pulmonary hypertension: a mixed-methods study

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