Abstract
IntroductionChronic thromboembolic pulmonary hypertension (CTEPH) is a potentially life-threatening condition associated with high morbidity and mortality. However, advances in medical, surgical and interventional treatment have markedly improved the outcome of patients with CTEPH. Additional factors potentially influencing quality of life (QoL) and outcome in CTEPH are yet to be defined. Child maltreatment is a major risk factor for unfavorable behavioral, mental as well as physical health outcomes and has been associated with decreased QoL. To date, no study assessed the impact of childhood trauma in patients with CTEPH.MethodsPatients with CTEPH were invited to complete the Childhood Trauma Questionnaire (CTQ). Data were compared to prevalence data from the German population. Mental well-being was assessed using the Hospital Anxiety and Depression Scale (HADS) and quality of life was measured using the WHO Quality of Life Questionnaire (WHOQOL). Furthermore, lifestyle factors and physical health parameters were studied.Logistic regression analysis was used to investigate a possible impact of child maltreatment on markers of disease severity.ResultsOne-hundred and seven patients with CTEPH completed the CTQ. These patients reported higher rates of emotional abuse and physical abuse and emotional neglect compared to the German population while rates of physical neglect and sexual abuse did not differ between patients and German population with prevalence of 20.6% for emotional abuse, 20% for physical abuse, 22% for emotional neglect, 46% for physical neglect, and 6% for sexual abuse in patients with CTEPH. Higher CTQ scores were associated with anxiety symptoms as well as negatively associated with QoL. No direct impact of childhood trauma on CTEPH severity was found.ConclusionWe found a higher rate of child maltreatment in patients with CTEPH in comparison to the German population. Correlations suggest moderate associations between CTQ scores and mental health and QoL. Child maltreatment had no significant impact on disease severity. Further investigation on proper interventions to support affected patients is needed.
Highlights
Chronic thromboembolic pulmonary hypertension (CTEPH) is a chronic disease occurring as a possible complication after pulmonary embolism
Global prevalence rates for subtypes of child maltreatment are being reported as 12.7% for sexual abuse, 22.6% for physical abuse, 36.3% for emotional abuse, 16.3% for physical neglect, and 18.4% for emotional neglect [12] as well as about one third of a German representative population sample experiencing at least one type of child maltreatment [13]
We investigated the prevalence of childhood maltreatment and its association with mental well-being, quality of life, and physical health in patients with CTEPH
Summary
Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially life-threatening condition associated with high morbidity and mortality. Despite improvements in treatment and increased life expectancy, quality of life is impaired in comparison to the general population [8, 9], and concomitant mental disorders have shown to be associated with impaired physical health [10]. The experience of child maltreatment is associated with a higher risk of developing type 2 diabetes [26] with its association being partly mediated by obesity, smoking and high blood pressure [27, 28]. It is related with a higher risk of developing chronic obstructive pulmonary disease (COPD) as well [26, 29] and with respiratory diseases in general [30, 31]. We assessed the prevalence of child maltreatment using the Childhood Trauma Questionnaire (CTQ) and compared it with the prevalence of the general German population
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