Depressive Symptoms in Pulmonary Arterial Hypertension: Prevalence and Association With Functional Status

McCollister, Deborah H.; Beutz, Michelle; McLaughlin, Vallerie V.; Rumsfeld, John S.; Masoudi, Frederick A.; Tripputi, Mark; Yaeger, Thomas; Weintraub, Philippe; Badesch, David B.

doi:10.1176/appi.psy.51.4.339

Cited by 52 publications

(47 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a previous study which used the Depression Anxiety Stress Scale (DASS), it was found that 22% of PAH patients had abnormal scores and were receiving psychopharmacological treatment [13]; thus, this study found a frequency of mood disorders in PAH which was comparable to that of the normal population. Other studies report varying results from 8 to 32% of treated mentally disordered patients with the use of different types of questionnaires [9,10,11]. In our study, patients previously diagnosed and treated for mood disorders had worse HADS scores than patients without psychopharmacological treatment.…”

Section: Discussioncontrasting

confidence: 41%

“…In our study, patients previously diagnosed and treated for mood disorders had worse HADS scores than patients without psychopharmacological treatment. This indicates that their mood disorder is undertreated, an unsatisfactory fact that has been previously described in PH [10,11,12]. …”

Section: Discussionmentioning

confidence: 92%

“…Several studies have shown that depression and anxiety are frequently reported symptoms in PH [9,10,11,12,14], and thus screening for mental disorders has been recommended [25,26]. …”

Section: Discussionmentioning

confidence: 99%

“…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]. …”

Section: Introductionmentioning

confidence: 99%

“…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]. …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

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

et al. 2016

View full text Add to dashboard Cite

Background: Pulmonary hypertension (PH) leads to reduced health-related quality of life (HRQoL). Objective: To investigate the prevalence and course of anxiety and depression and their association with HRQoL, disease severity and survival in PH. Methods: 131 PH patients (91 pulmonary arterial, 30 chronic thromboembolic, 10 due to lung disease; 84 female, 47 male) had repeated assessments with the Hospital Anxiety and Depression Scale (HADS), HRQoL, six-minute walk distance and WHO functional class during a mean course of 16 ± 12 months. Results: Among the 49 incident and 82 prevalent PH patients, the HADS score was positive in 53%/21% (depression), 51%/24% (anxiety) and 63%/26% (total score) (all p < 0.05). The HADS score was improved at the second assessment in incident patients. The HADS score correlated with HRQoL at all consecutive assessments and with functional class until the third assessment, but not with baseline hemodynamics, age or gender. Conclusion: Mood disorders remain underdiagnosed in PH. The higher prevalence of anxiety/depression in incident versus prevalent patients and the improvement over time may indicate an amelioration of mood disorders after PH diagnosis and treatment.

show abstract

Section: Discussioncontrasting

confidence: 41%

Section: Discussionmentioning

confidence: 92%

“…Several studies have shown that depression and anxiety are frequently reported symptoms in PH [9,10,11,12,14], and thus screening for mental disorders has been recommended [25,26]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…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]. …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2016

View full text Add to dashboard Cite

show abstract

Cognitive and behavioral processes predict anxiety and depression in patients with pulmonary hypertension

et al. 2022

View full text Add to dashboard Cite

Emotional and psychological difficulties cannot fully be explained by disease‐related factors in people with pulmonary hypertension (PH). This study examined the relationship between anxiety, depression, demographic, objective and subjective PH factors, and self‐reported cognitive and behavioral processes, which have been associated with mood in clinical and nonclinical samples. This is a secondary analysis of baseline data from 77 adults with PH who took part in a randomized controlled trial of a self‐help intervention targeting anxiety in PH. Participants completed self‐report measures including: demographic (age, gender, ethnicity, education, employment) and clinical questionnaire (PH diagnosis, functional class, years since diagnosis), depression (PHQ‐9), anxiety (GAD‐7), health‐related quality of life (emPHAsis‐10), dyspnea (D12), and cognitive and behavioral processes (CBP‐Q) scale. Data were analyzed using correlational and regression analyses. Overall, 70% and 63% of participants scored above the clinical cut off for anxiety and depression, respectively. Demographics were not associated with anxiety or depression. PH‐related factors were correlated with depression but not anxiety. A multiple regression analysis suggested dyspnea and cognitive processes significantly predicted anxiety whereas behavioral processes were not a unique predictor. In contrast, dyspnea and behavioral processes predicted depression whereas cognitive processes did not. While a body of evidence exists demonstrating people with PH are more likely to experience anxiety and depression, less is known about factors that cause and maintain these disorders. Findings highlight the significance of subjective factors that could be a target for screening and psychological treatments for emotional difficulties, such as cognitive behavioral therapy.

show abstract

Impact of the COVID‐19 pandemic on chronic disease management and patient reported outcomes in patients with pulmonary hypertension: The Pulmonary Hypertension Association Registry

et al. 2023

View full text Add to dashboard Cite

To better understand the impact of the COVID‐19 pandemic on the care of patients with pulmonary hypertension, we conducted a retrospective cohort study evaluating health insurance status, healthcare access, disease severity, and patient reported outcomes in this population. Using the Pulmonary Hypertension Association Registry (PHAR), we defined and extracted a longitudinal cohort of pulmonary arterial hypertension (PAH) patients from the PHAR's inception in 2015 until March 2022. We used generalized estimating equations to model the impact of the COVID‐19 pandemic on patient outcomes, adjusting for demographic confounders. We assessed whether insurance status modified these effects via covariate interactions. PAH patients were more likely to be on publicly‐sponsored insurance during the COVID‐19 pandemic compared with prior, and did not experience statistically significant delays in access to medications, increased emergency room visits or nights in the hospital, or worsening of mental health metrics. Patients on publicly‐sponsored insurance had higher healthcare utilization and worse objective measures of disease severity compared with privately insured individuals irrespective of the COVID‐19 pandemic. The relatively small impact of the COVID‐19 pandemic on pulmonary hypertension‐related outcomes was unexpected but may be due to pre‐established access to high quality care at pulmonary hypertension comprehensive care centers. Irrespective of the COVID‐19 pandemic, patients who were on publicly‐sponsored insurance seemed to do worse, consistent with prior studies highlighting outcomes in this population. We speculate that previously established care relationships may lessen the impact of an acute event, such as a pandemic, on patients with chronic illness.

show abstract

Depressive Symptoms in Pulmonary Arterial Hypertension: Prevalence and Association With Functional Status

Cited by 52 publications

References 42 publications

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

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

Cognitive and behavioral processes predict anxiety and depression in patients with pulmonary hypertension

Impact of the COVID‐19 pandemic on chronic disease management and patient reported outcomes in patients with pulmonary hypertension: The Pulmonary Hypertension Association Registry

Contact Info

Product

Resources

About