Anxiety and depression disorders in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension

Abstract

BackgroundThe objective of this prospective study was to assess the prevalence of anxiety and depression disorders and their association with quality of life (QoL), clinical parameters and survival in patients with pulmonary hypertension (PH).MethodsWe prospectively assessed 158 patients invasively diagnosed with pulmonary arterial hypertension (n = 138) and inoperable chronic thromboembolic PH (n = 20) by clinical measures including quality of life (QoL, SF-36 questionnaire), cardiopulmonary exercise testing and six minute walking distance and by questionnaires for depression (PHQ-9) and anxiety (GAD-7). According to the results of the clinical examination and the questionnaires for mental disorders (MD) patients were classified into two groups, 1) with moderate to severe MD (n = 36, 22,8%), and 2) with mild or no MD (n = 122). Patients were followed for a median of 2.7 years. Investigators of QoL, SF-36 were blinded to the clinical data.ResultsAt baseline the 2 groups did not differ in their severity of PH or exercise capacity. Patients with moderate to severe MD (group 1) had a significantly lower QoL shown in all subscales of SF-36 (p < 0.002). QoL impairment significantly correlated with the severity of depression (p < 0.001) and anxiety (p < 0.05). During follow-up period 32 patients died and 3 were lost to follow-up. There was no significant difference between groups regarding survival. Only 8% of the patients with MD received psychopharmacological treatment.ConclusionAnxiety and depression were frequently diagnosed in our patients and significantly correlated with quality of life, but not with long term survival. Further prospective studies are needed to confirm the results.

Support Experienced by Patients Living with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension

“…Many patients wished to talk about the challenges of daily life with some professional in or outside the PAH team. Given the burden of disease-specific symptoms such as anxiety, depression, financial and relationship difficulties [19,20], healthcare professionals should take a more holistic view and provide psychosocial support for improvement of PAH and CTEPH patients' well-being.…”

Prevalence of Anxiety and Depression in Pulmonary Hypertension and Changes during Therapy

“…Furthermore, patients often appear healthy at rest and thus might not be taken seriously by health care providers or their environment in their constrained daily life [8]. Anxiety and depression are highly prevalent in chronic diseases and have also been commonly found in prevalent PAH patients under chronic therapy [9,10,11,12,13,14,15,16]. …”

“…Studies which conducted screening for depression with standardized instruments, mainly self-administered questionnaires, found a prevalence ranging from 10 to 55% [9,10,11,12,13,14]. …”

Depressive Status in Patients With Chronic Thromboembolic Pulmonary Hypertension

“…All participants provided informed consent. The study protocol and analyses of the data obtained were 10 This discrepancy should be investigated further in large prospective studies in the future. However, the findings in this study may suggest that symptoms such as dyspnea, due to CTEPH, would not be the cause of depressive status in CTEPH.…”