TY - JOUR
T1 - Depression, anxiety and psychological distress in patients with pulmonary hypertension
T2 - A mixed-methods study
AU - Takita, Yuka
AU - Takeda, Yuko
AU - Fujisawa, Daisuke
AU - Kataoka, Masaharu
AU - Kawakami, Takashi
AU - Doorenbos, Ardith Z.
N1 - Funding Information:
Funding This study was supported by Japan Society for the Promotion of Science KAKENHI Grant-in-Aid for Challenging Exploratory Research (Grant Number: JP17K19839). The research was also supported in part by the National Institute of Nursing Research of the National Institutes of Health (Award Number: K24NR015340).
Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2021/4/29
Y1 - 2021/4/29
N2 - Pulmonary hypertension (PH) is a chronic and progressive disease. While prognoses have improved, PH patients still experience side effects and activity restrictions. Accordingly, the key questions asked by this study are ‘How many PH patients have depression/anxiety symptoms?’ and ‘Is there a difference in the symptoms and distress factors between pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH) patients, and how are they experiencing distress?’ A mixed-methods study was conducted to collect and analyse quantitative and qualitative data. We administered questionnaires (Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder-7) and then conducted interviews with participants who reported moderate to severe depressive symptoms (PHQ-9 ≥10). Seventy-four participants were enrolled in the study, 25 with idiopathic PAH and 49 with CTEPH. Their average age was 55.2 years (PAH 42.7 years, CTEPH 61.5 years). Overall, 44.6% of participants had mild or more severe depressive symptoms (PHQ-9 ≥5) and 17.6% had moderate or more severe depressive symptoms (PHQ-9 ≥10). PAH patients had particularly high depressive symptoms (PHQ-9 ≥5: PAH 64.0%, CTEPH 34.7%; PHQ-9 ≥10: PAH 24%, CTEPH 14.3%). We extracted four common themes from the qualitative interview data on participants’ experience of psychological distress: ‘Loss of myself,’ ‘Isolation from my surroundings,’ ‘Hassle associated with oxygen therapy,’ and ‘Fear of illness progression/deterioration.’ One theme— ‘Suffering from side effects’—was extracted only for PAH patients, while another—‘Rumination on illness due to breathlessness’—was extracted only for CTEPH patients. The study found that PH patients are prone to depression. The identification of factors and themes that influence the psychological distress of PH patients is important information that can be used to improve the support for the physical and mental health of these patients. Interventions for these distress may contribute to improving the mental status of PH patients.
AB - Pulmonary hypertension (PH) is a chronic and progressive disease. While prognoses have improved, PH patients still experience side effects and activity restrictions. Accordingly, the key questions asked by this study are ‘How many PH patients have depression/anxiety symptoms?’ and ‘Is there a difference in the symptoms and distress factors between pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH) patients, and how are they experiencing distress?’ A mixed-methods study was conducted to collect and analyse quantitative and qualitative data. We administered questionnaires (Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder-7) and then conducted interviews with participants who reported moderate to severe depressive symptoms (PHQ-9 ≥10). Seventy-four participants were enrolled in the study, 25 with idiopathic PAH and 49 with CTEPH. Their average age was 55.2 years (PAH 42.7 years, CTEPH 61.5 years). Overall, 44.6% of participants had mild or more severe depressive symptoms (PHQ-9 ≥5) and 17.6% had moderate or more severe depressive symptoms (PHQ-9 ≥10). PAH patients had particularly high depressive symptoms (PHQ-9 ≥5: PAH 64.0%, CTEPH 34.7%; PHQ-9 ≥10: PAH 24%, CTEPH 14.3%). We extracted four common themes from the qualitative interview data on participants’ experience of psychological distress: ‘Loss of myself,’ ‘Isolation from my surroundings,’ ‘Hassle associated with oxygen therapy,’ and ‘Fear of illness progression/deterioration.’ One theme— ‘Suffering from side effects’—was extracted only for PAH patients, while another—‘Rumination on illness due to breathlessness’—was extracted only for CTEPH patients. The study found that PH patients are prone to depression. The identification of factors and themes that influence the psychological distress of PH patients is important information that can be used to improve the support for the physical and mental health of these patients. Interventions for these distress may contribute to improving the mental status of PH patients.
KW - primary pulmonary hypertension
KW - psychology
UR - http://www.scopus.com/inward/record.url?scp=85105220049&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85105220049&partnerID=8YFLogxK
U2 - 10.1136/bmjresp-2021-000876
DO - 10.1136/bmjresp-2021-000876
M3 - Article
C2 - 33926959
AN - SCOPUS:85105220049
SN - 2052-4439
VL - 8
JO - BMJ Open Respiratory Research
JF - BMJ Open Respiratory Research
IS - 1
M1 - e000876
ER -
