Association of Psychopathology Symptoms, Self-Compassion, and Forgiveness in Patients With Pulmonary Embolism

Foteini Malli; Ioannis C Lampropoulos; Giorgos Iatrou; Ourania S Kotsiou; Fotini Bardaka; Evangelia Kotrotsiou; Evangelos C Fradelos; Konstantinos Gourgoulianis; Zoe Daniil

doi:10.7759/cureus.19951

Association of Psychopathology Symptoms, Self-Compassion, and Forgiveness in Patients With Pulmonary Embolism

Cureus. 2021 Nov 27;13(11):e19951. doi: 10.7759/cureus.19951. eCollection 2021 Nov.

Authors

Foteini Malli^{1

2}, Ioannis C Lampropoulos², Giorgos Iatrou², Ourania S Kotsiou³, Fotini Bardaka², Evangelia Kotrotsiou⁴, Evangelos C Fradelos⁵, Konstantinos Gourgoulianis⁶, Zoe Daniil²

Affiliations

¹ Faculty of Nursing/Respiratory Disorders Lab, University of Thessaly, Larissa, GRC.
² Respiratory Medicine Department, University of Thessaly, Larissa, GRC.
³ Respiratoty Medicine Department, University of Thessaly, Larissa, GRC.
⁴ General Department, University of Thessaly, Larissa, GRC.
⁵ Faculty of Nursing, University of Thessaly, Larissa, GRC.
⁶ Faculty of Medicine/Respiratory Medicine Department, University of Thessaly, Larissa, GRC.

Abstract

Background Pulmonary embolism (PE) is a potentially life-threatening disease with both physical and psychological impacts. The psychological distress in the early phase of the disease has not been previously studied in the literature. Methods The study sample included patients with PE with or without deep vein thrombosis. All subjects included in the study prospectively completed the Symptom Checklist-90-R (SCL-90-R) questionnaire, the Heartland Forgiveness Scale (HFS), and the Self-Compassion Scale (SCS) during their hospitalization for PE. Results Forty-four PE patients were included in the study (59.1% males). The mean age was 62.27±15.03 years. The majority (77.3%) had at least one comorbidity with 9.1% previously diagnosed with depression. The Total Global Severity Index (GSI) score for SCL-90-R was 82.42±49.70 while 36.4% of subjects had a high "Obsessive-compulsive" score, 22.7% had a high "Depression" score, and 22.7% presented a high "Hostility" score. The total HFS score was 45.54±40.42 with 54.5% of patients classified as "usually forgiving." The mean SCS score was 2.05±0.65 with 59.1% of patients presenting moderate self-compassion while 18.2% had low self-compassion. The total SCS score was correlated with the total GSI score (p=0.005, r=-0.576) and total HFS score (p=0.005, r=0.675). The SCS Self-kindness score correlated with interpersonal sensitivity (p=0.024, r=-0.479), depression (p=0.008, r=-0.551), and GSI score (p=0.049, r=-0.425). Self-judgement correlated with paranoid ideation (p=0.044, r=-0.467), hostility (p=0.007, r=-0.597), and GSI (p=0.027, r=-0.505). Isolation correlated with interpersonal sensitivity (p=0.026, r=-0.509), anxiety (p=0.014, r=-0.553), hostility (p=0.032, r=-0.494), paranoid ideation (p=0.026, r=-0.509), and GSI (p=0.015, r=-0.548). The total SCS score correlated with anxiety (p=0.041, r=-0.438). SCS Self-kindness score correlated significantly with total HFS score (p=0.002, r=0.613), forgiveness of self (p=0.011, r=0.528), forgiveness of others (p=0.008, r=0.550), and forgiveness of situations (p=0.004. r=0.587). Common humanity was significantly correlated with total HFS score (p=0.023, r=0.481), forgiveness of others (p=0.033, r=0.456), and forgiveness of situations (p=0.016, r=0.507). Mindfulness was positively correlated with HFS total score (p=0.009, r=0.544), forgiveness of self (p=0.049, r=0.424), forgiveness of others (p=0.012, r=0.525), and forgiveness of situations (p=0.013, r=0.520). Conclusions We report for the first time that patients acutely hospitalized for PE present symptoms of obsessive-compulsive disorder, depression, and hostility and exhibit moderate self-compassion. The marginal majority of PE patients are "usually forgiving" during the acute phase of the disease. Self-compassion is positively associated with forgiveness and negatively associated with psychiatric symptoms. Further studies are warranted in order to assess longitudinal differences in psychometric scores and the possible result of targeted mental health interventions at PE-specific clinical outcomes.

Keywords: forgiveness; mental health; pulmonary embolism; scl-90-r; self-compassion; venous thromboembolism.

Grants and funding

The present was supported by a grant by the Research Committee of the University of Thessaly. The sponsor of the study had no role in study design, data collection, data analysis, data interpretation, or the writing of the report. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.