Anxiety, Depression and Quality of Life in Pulmonary Hypertension: A Comparison of Incident and Prevalent Cases

Abstract

<b><i>Introduction:</i></b> Anxiety and depression are common in pulmonary hypertension (PH) and health-related quality of life (HRQoL) is reduced. Sufficient analyses in incident and prevalent patients are lacking, so we provide a comparative analysis of these groups with focus on anxiety, depression and HRQoL. <b><i>Methods:</i></b> Depression, anxiety and HRQoL were retrospectively analyzed by Hospital Anxiety and Depression Scale (HADS) and Short Form 36 questionnaire in 91 prevalent and 21 incident PH outpatients from a German tertiary care center specialized in PH. The acquired data as well as hemodynamic and functional parameters of prevalent and incident cases were compared. <b><i>Results:</i></b> HRQoL was reduced in both cohorts of patients. Incident patients had significantly worse HRQoL in physical dominated scales than prevalent patients (physical component summary score: <i>p</i> = 0.02; physical role performance: <i>p</i> &#x3c; 0.01). Depression and anxiety were more pronounced in prevalent patients (elevated depression scales: 28.6% of incident group, 35.2% of prevalent group, elevated anxiety scores: 28.6% of incident group, 39.6% of prevalent group). The groups did not differ in hemodynamic data, but incident patients had significantly lower cardiac biomarkers such as NT-proBNP (<i>p</i> = 0.016) and hs-troponin (<i>p</i> = 0.017). The time since diagnosis was a predictor of the subscale physical role performance (<i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> Physical domains of HRQoL seem to be more limited in incident patients with PH. Anxiety and depression are frequent in both groups. A screening for anxiety and depression is important from the onset of the diagnosis, and patients should receive appropriate therapy to improve HRQoL, anxiety and depression.