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Erschienen in: Lung 6/2017

09.10.2017 | PULMONARY VASCULAR DISEASE

Anxiety, Depression, and Health-Related QOL in Patients Diagnosed with PAH or CTEPH

verfasst von: Elena Pfeuffer, Holger Krannich, Michael Halank, Heinrike Wilkens, Philipp Kolb, Berthold Jany, Matthias Held

Erschienen in: Lung | Ausgabe 6/2017

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Abstract

Background

Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are life-threatening diseases with a high burden of symptoms. Although depression, anxiety, and reduced health related quality of life (HRQOL) have also been reported, a comparative analysis which explores these traits and their underlying factors was lacking.

Methods

A retrospective analysis of depression, anxiety, and health related QOL was conducted using a Hospital anxiety and depression scale (HADS) as well as the SF-36 HRQOL questionnaire. Results from these tools were compared with haemodynamic and functional parameters in 70 PAH and 23 CTEPH outpatients from a German tertiary care center specializing in pulmonary hypertension.

Results

Although HRQOL was reduced in both cohorts of patients, individuals diagnosed with CTEPH scored lower in nearly all SF-36 parameters. Significance was noted in both “mental health” (p = 0.01) and “mental component summary score” (MCS) (p = 0.02). Depression was also more frequent in patients with CTEPH (56%) than in patients with PAH (30%), (p = 0.03). Overall, depression and anxiety correlated with most SF-36 scales in both PAH and CTEPH. In CTEPH, depression also correlated with the Borg Dyspnea Scale (r = 0.44, p = 0.01). These patients also had significantly lower pCO2 levels than the PAH cohort reflecting more severe ventilation/perfusion mismatch. All other haemodynamic and functional parameters did not differ across the groups.

Conclusion

While both cohorts of patients suffer from a reduced HRQOL as well as depression and anxiety, decreases in mental health parameters are more pronounced in the CTEPH cohort. This suggests a strong effort to improve early detection, especially in dyspneic patients with classical risk factors for CTEPH and PAH and argues for mental illness interventions alongside routine clinical care provided to patients diagnosed with PAH or CTEPH.
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Metadaten
Titel
Anxiety, Depression, and Health-Related QOL in Patients Diagnosed with PAH or CTEPH
verfasst von
Elena Pfeuffer
Holger Krannich
Michael Halank
Heinrike Wilkens
Philipp Kolb
Berthold Jany
Matthias Held
Publikationsdatum
09.10.2017
Verlag
Springer US
Erschienen in
Lung / Ausgabe 6/2017
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-017-0052-z

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