Abstract
IntroductionMental disorders are common in patients with pulmonary arterial hypertension (PAH) and contribute to impaired quality of life (QoL). The impact of mental disorders on access to health care, differences in clinical parameters and treatment in patients with PAH is unclear. In this study we sought to assess the impact of mental disorders and other health disparities on health-care-utilization in patients with PAH.MethodsIn a cross-sectional observational study of patients with PAH, mental disorders were characterized using a structed clinical interview. In addition, patients completed a self-administered questionnaire to assess QoL, symptoms of anxiety and depression, lifestyle-factors and educational status. Number of outpatient visits and communication events per year were calculated as a surrogate for health-care-utilization and were compared by the presence of mental disorder. Linear regression analysis was conducted to assess the impact on health-care-utilization.Results117 patients with PAH participated in this study (70% female, median age 59 (interquartile range, 49–70) years). Significant differences between patients with or without mental disorders were found in anxiety, depression and QoL. There were no significant differences in clinical parameters. Patients with mental disorders had higher rates of outpatient visits and communication events than patients without mental disorders. Linear regression revealed a gain of 2.2 communication events per year in the presence of any mental disorders.ConclusionMental disorders in patients with PAH are common and significantly affect health-care-utilization. This higher demand in patients with mental disorder needs to be addressed by physicians, psychiatrists and specialized nurses offering therapeutic strategies.
Highlights
Mental disorders are common in patients with pulmonary arterial hypertension (PAH) and contribute to impaired quality of life (QoL)
Twenty six patients presented with major depression disorder (MDD) and 10 patients with panic disorder (PD) resulting in 31 (27%) patients
Disease severity indicated by WHO functional class (FC), 6-minute walk distance (6MWD), NTproBNP, DLCO, hemodynamics at time of diagnosis as well as Pulmonary arterial hypertension (PAH) treatment did not differ between patients with or without mental disorders (Table 1)
Summary
Mental disorders are common in patients with pulmonary arterial hypertension (PAH) and contribute to impaired quality of life (QoL). PAH remains a fatal illness with right heart failure being the primary cause of death [4] Mental disorders such as major depression disorder (MDD) or panic disorder (PD) are common in patients with PAH, and patient’s quality of life, mental health, and access to medical care have been addressed in recent studies [5–10]. The prevalence of anxiety, depression and adjustment disorders in patients with PAH correlate with disease progression, intensity of symptoms as well as functional impairment [11, 12]. Mental disorders such as major depression disorder, panic disorder or adjustment disorder are common in patients with PAH [13]
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