Anxiety and depression in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: Results from a Chinese survey

Xia Zhou; Hui Shi; Yuanhua Yang; Zuoqing Zhang; Zhenguo Zhai; Chen Wang

doi:10.3892/etm.2020.8566

Anxiety and depression in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: Results from a Chinese survey

Exp Ther Med. 2020 Apr;19(4):3124-3132. doi: 10.3892/etm.2020.8566. Epub 2020 Feb 27.

Authors

Xia Zhou¹, Hui Shi², Yuanhua Yang³, Zuoqing Zhang¹, Zhenguo Zhai^{4

5}, Chen Wang^{4

5}

Affiliations

¹ Department of Respiratory Medicine, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing 100043, P.R. China.
² Department of Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100029, P.R. China.
³ Department of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100029, P.R. China.
⁴ Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Peking University Health Science Center, Beijing 100029, P.R. China.
⁵ Department of Respiratory Medicine, Capital Medical University, Beijing 100069, P.R. China.

Abstract

Limited studies have focused on mental symptoms (anxiety and depression) and their impact on quality of life (QoL) in patients with pulmonary hypertension (PH). The objective of the present study was to assess the prevalence of anxiety and depression and their association with QoL in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH) in a Chinese population. Patients diagnosed with PH by right heart catheterization between March 2015 and February 2016 were recruited. QoL [short form 36 Health Survey Questionnaire (SF-36)] and depression (Patient Health Questionnaire depression scale-9) and anxiety (Generalized Anxiety Disorder-7) were assessed at baseline. Patients were followed up every 3 months. A total of 36 patients with PAH and 62 patients with CTEPH were enrolled. According to the results of the clinical examination and the questionnaires for depression and anxiety, patients were divided into two groups: Group 1, with depression and/or anxiety (n=65, 66.3%) and group 2, without depression or anxiety (n=33, 33.7%). At baseline, the two groups did not differ in their hemodynamics. Patients with depression and/or anxiety (group 1) had a significantly lower score in all subscales of SF-36 (P<0.05). The impairment of QoL significantly correlated with the severity of depression (P<0.001) and anxiety (P<0.05). During the follow-up period, end-point events (death or admission due to deterioration) occurred in 17 patients (17.3%); 8 patients (8.1%) were lost to follow-up. The end-point event-free survival rate in group 2 was significantly higher than that in group 1. Multivariate logistic regression analysis suggested that the financial situation and right ventricular enlargement were influencing factors of depression and/or anxiety. In conclusion, in patients with PH from a Chinese population, anxiety and depression were frequently encountered and significantly correlated with QoL. The significant relevant factors influencing anxiety/depression were the financial situation and right ventricular enlargement and patients with depression had a worse prognosis than those without.

Keywords: anxiety; depression; influencing factors; pulmonary hypertension; survival.