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The Prevalence of Psychological Distress in Pulmonary Hypertension

Tania Von Visger

K. Kuntz

G. Phillips

E. Chipps

J. Bauman

Namita Sood


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Conference: 2012 International PHA Conference and Scientific Sessions

Release Date: 06.22.2012

Presentation Type: Abstracts

Von Visger, T; Kuntz, K; Phillips, G; Chipps, E; Bauman, J; Sood, N

The Ohio State University Medical Center, Columbus, OH, USA

BACKGROUND: Primary Pulmonary Hypertension (PPH) is a rare clinical condition characterized by progressive parenchymal and vascular changes resulting in elevated pulmonary artery pressure. It has a relatively young age of onset with rapid progression of illness. Among many other factors, the limited number of available therapies and the complex medication delivery systems can be distressing to patients. As a result, psychological health may be greatly impacted by this disease. The primary purpose of this study is to describe the prevalence of depression and anxiety in PPH patients.

METHOD: Adult patients from the Pulmonary Clinic with a confirmed PPH diagnosis were included in this cross-sectional survey design. In addition to medical chart review, participants completed basic demographic information as well as some questions evaluating psychosocial concerns. This included the Patient Health Questionnaire-10 (PHQ-10). On this instrument, patients endorse the presence or absence of symptoms of various mental health problems such as: major depressive disorder, “other” depressive disorder (minor depression), panic disorder, and “other” anxiety disorder (generalized anxiety disorder). In addition, the number of months since learning of their diagnosis was recorded to assess for any correlation between distress and time since their diagnosis.

RESULTS: In a preliminary review of results, fifty-three participants provided data for analysis. Participants ranged in age from 21 to 53 (mean= 52.1 years, SD= 14.0). The majority were female (88.7%) and 50.9% were married. The majority of participants were Caucasian (73.6%). Percentage of patients with NYHA functional classification Class I, II, III, and IV were: 3.8%, 50.9%, 39.6%, and 5.7%, respectively. Time since the PPH diagnosis ranged from 1 to 84 months (mean= 34.3, SD= 22.1). A large number of patients endorsed criteria for at least one psychiatric diagnosis (28.3%); 15.1% reported major depressive disorder, 15.1% reported other depressive disorder, 10.0% reported panic disorder, 11.8% and reported other anxiety disorder. In a statistical analysis (Spearman’s rank correlation-rho), there were no significant correlations between psychiatric diagnoses and time since diagnosis.

CONCLUSIONS: There are a known variety of reasons why patients may have difficulty coping with PPH. In this sample, a number of patients endorsed having depressive and anxiety conditions. It is well established that psychological distress can have implications for poorer compliance, increased hospitalizations/treatment costs, and worse quality of life. Therefore, it is imperative that providers assess and provide appropriate treatment referral to patients when these conditions are recognized.