Emotional symptoms and quality of life in patients with pulmonary arterial hypertension.
BACKGROUND
Limited evidence exists on the nature and degree of emotional problems in pulmonary arterial hypertension (PAH) and their association with patients' health-related quality of life (HRQOL).


METHODS
This cross-sectional study examined the presence of depression, anxiety, and stress symptoms, and their association with disease-specific and generic HRQOL. A total of 101 patients (73% women) with PAH (age, 55.4 ± 16.4 years; 42.6% in New York Heart Association [NYHA] class II) completed the Depression, Anxiety, and Stress Scale, the generic Medical Outcomes Study Short-Form 36-Item (SF-36) Health Survey, and the disease-specific Minnesota Living With Heart Failure Questionnaire (MLHFQ) HRQOL instrument. The association between emotional problems and HRQOL was determined using multivariable linear regression analyses, controlling for demographic and disease-related characteristics.


RESULTS
Of the patients, 32.6%, 48%, and 27.6% experienced depressive, anxiety or stress symptoms, respectively. HRQOL was >1 standard deviation below population norms for the SF-36 Physical Component Summary. Depressive symptoms, NYHA class, and being disabled explained 46% of the total variance of the MLHFQ. Emotional problems did not contribute to the SF-36 Physical Component Summary but explained part of the variance of the physical sub-scales of the SF-36 role limitations due to physical problems, bodily pain, and general health.


CONCLUSIONS
The high presence of emotional problems warrants regular screening and appropriate psychotherapeutic and/or pharmacological treatment. Which strategies could improve PAH patients' HRQOL remains to be investigated.
Health Services and Nursing Research, Department of Public Health and Primary Care.
Jasper
J
M M Vanhoof
Respiratory Division, University Hospitals, and Department of Clinical and Experimental Medicine, University of Leuven, (KU Leuven) Leuven, Belgium.
Marion
M
Delcroix
Respiratory Division, University Hospitals, and Department of Clinical and Experimental Medicine, University of Leuven, (KU Leuven) Leuven, Belgium.
Ellen
E
Vandevelde
TriloStatistical Consultancy, Basel, Switzerland.
Kris
K
Denhaerynck
Respiratory Division, University Hospitals, and Department of Clinical and Experimental Medicine, University of Leuven, (KU Leuven) Leuven, Belgium.
Wim
W
Wuyts
Respiratory Division, University Hospitals, and Department of Clinical and Experimental Medicine, University of Leuven, (KU Leuven) Leuven, Belgium.
Catharina
C
Belge
Health Services and Nursing Research, Department of Public Health and Primary Care. Electronic address: fabienne.dobbels@med.kuleuven.be.
Fabienne
F
Dobbels
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004644:Emotions / Q000502:physiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology* / Q000523:psychology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology
Pulmonary arterial hypertension; mood problems; psychological functioning; quality of life