Depression and Anxiety in Patients With Pulmonary Hypertension: The Role of Life Satisfaction and Optimism

Abstract

Pulmonary hypertension is a highly disabling condition characterized by a progressive increase in pulmonary arterial pressure. Even though pulmonary hypertension may cause great emotional distress, research examining the determinants of patients' emotional well-being has been scarce and has mostly focused on the role of disease-related factors. This study examined whether patients' emotional well-being may be effected by their life circumstances. Sixty-four patients with pulmonary hypertension completed measures of symptoms of pulmonary hypertension, functional disability, depression and anxiety symptoms, life satisfaction, optimism, and quality of life (QoL). Clinically-significant symptoms of depression and anxiety were only accurately predicted in 50.5% and 56.5% of patients, respectively, based on disease severity alone. However, the addition of life satisfaction and optimism to the models improved the prediction of depressive and anxiety symptomatology. Further, symptoms of anxiety were a significant predictor of QoL, above and beyond disease severity. Patients with considerably different levels of disease severity may develop clinically-significant depressive and anxiety symptomatology. This suggests that there is not a perfect correspondence between the level of disease severity and the repercussions thereof across patients. Accordingly, these results suggest that emotional well-being may be better explained by taking into consideration patients' life circumstances, as these may modulate the repercussions of having pulmonary hypertension. The results also showed that anxiety symptoms constituted an extra burden to patients' QoL. The higher prevalence in this sample of clinically-significant symptoms of anxiety, compared to that of depression, suggest that feelings of fear and uncertainty may require special attention among patients with pulmonary hypertension.