Conference: 2009 PH Resource Network Symposium
Release Date: 09.24.2009
Presentation Type: Abstracts
Deborah McCollister, RN, BSN; Michelle Beutz, MD; Vallerie McLaughlin, MD; John Rumsfeld, MD; Fred Masoudi, MD; Mark Tripputi, MS; John Kittelson, PhD; Tom Yaeger, BS; Philippe Weintraub, MD; David Badesch, MD
University of Colorado, Denver, CO; University of Michigan, Ann Arbor, MI
BACKGROUND: The prevalence of depressive symptoms and their impact on patients with pulmonary arterial hypertension (PAH) is understudied. A previous survey estimated the prevalence of major depressive disorder in patients with PAH to be 15.9%. The current study further investigates the prevalence of depressive symptoms in PAH, and their correlation with physical function.
METHODS: Consecutive outpatients with PAH (idiopathic, or associated with scleroderma, congenital heart disease, or anorexigen use) seen in the pulmonary hypertension clinics at U. of Colorado and U. of Michigan were screened. Eligible patients were >18 years of age with PAPm >25 mmHg by right heart catheterization and in WHO functional class (FC) II-IV. At two outpatient visits, baseline and 12 (+4) weeks later, patients were asked to complete the PHQ8, a well-validated instrument for grading severity of depressive symptoms, assessed for FC, and performed a 6-minute walk test (6MWD).
RESULTS: 100 patients, 88 female and 12 male, 50 with idiopathic disease, and 50 with associated conditions, were enrolled. At baseline, 38% were in FC II, and 61% FC III, and the mean 6MWD was 373m. 15% of subjects had evidence of major depression (PHQ8 score of >10), 40% had moderate depression (PHQ8 score 4-9), and 45% had none or mild depression (PHQ8 score 0-3). There was a trend toward a lower baseline 6MWD (342m vs. 378m p=0.18) in patients with major vs. mild/moderate depression. There was no statistically significant relationship between change in 6MWD over the 3 mo study period and baseline PHQ8 depression score (p=0.59).
CONCLUSIONS: Depression is common in patients with PAH, with 55% demonstrating moderate or major depressive symptoms, and may be associated with worse physical function as assessed by 6MWD. Patients with PAH should be assessed for depression.