Depression and post-traumatic stress disorder in individuals with hereditary hemorrhagic telangiectasia: A cross-sectional survey
Depression and post-traumatic stress disorder in individuals with hereditary hemorrhagic telangiectasia: A cross-sectional survey
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DOI：
10.1016/j.thromres.2017.03.003
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发表时间：
2017-05-01
影响因子：
7.5
通讯作者：
McCrae, Keith R.
中科院分区：
文献类型：
--
作者：
Chaturvedi, Shruti;Clancy, Marianne;McCrae, Keith R.
简介：遗传性出血性毛细血管扩张症（HHT）的特点是频繁的严重出血，特别是鼻出血，和危及生命的并发症，包括中风，脑脓肿和心力衰竭。HHT的心理影响尚不清楚。我们进行了这项横断面研究，以确定抑郁症和创伤后应激障碍（PTSD）相关HHT.Methods的患病率：一项调查工具，包括人口统计学和临床信息和两个有效的自我管理的问卷调查，创伤后应激障碍量表DSM-5（PCL-5）和贝克抑郁量表-II（BDI-II），被分发到个人与HHT。与临床和人口统计学变量与抑郁症和PTSDs. Results的关系进行了评估的logistic回归model.Results：共222人回答了调查。其中，185人完成了BDI II或PCL-5，并被纳入分析。中位年龄为54岁，142例（76.8%）为女性。分别有81名（43.8%）、59名（31.9%）和16名（8.6%）被调查者存在抑郁症、焦虑症和创伤后应激障碍的诊断。142例（88.7%）患者的BDI-II评分> 13，表明至少存在轻度抑郁症状，52例（28.1%）患者的PTSD筛查呈阳性（PCL-5评分>= 38）。多变量分析显示，抑郁症[OR 2.17（95%CI 1.045-4.489），p = 0.038]，焦虑障碍[OR 2.232（95%CI 1.066-4.676），p = 0.033]，失业[OR 2.234（95%CI 1.46-4.714），p = 0.019）与PTSD相关。结论：我们报道了HHT患者中抑郁和PTSD症状的高患病率。虽然选择偏倚可能导致本研究中对患病率的高估，但我们的结果令人担忧，临床医生应对心理困扰的迹象保持警惕，并考虑筛查这些疾病。(C)2017爱思唯尔有限公司版权所有
Introduction: Hereditary hemorrhagic telangiectasia (HHT) is characterized by frequent severe bleeding, particularly epistaxis, and life-threatening complications including stroke, brain abscess and heart failure. The psychological impact of HHT is not known. We conducted this cross sectional study to determine the prevalence of depression and post-traumatic stress disorder (PTSD) related to HHT.Methods: A survey tool comprising demographic and clinical information and two validated self-administered questionnaires, the PTSD checklist for DSM-5 (PCL-5) and Beck Depression Inventory-II (BDI-II), was distributed to individuals with HHT. Associations with clinical and demographic variables with depression and PTSD were evaluated in a logistic regression model.Results: A total of 222 individuals responded to the survey. Of these, 185 completed either the BDI II or PCL-5 and were included in the analysis. Median age was 54 years and 142 (76.8%) were female. An existing diagnosis of depression, anxiety disorder and PTSD was present in 81 (43.8%), 59 (31.9%) and 16(8.6%) respondents, respectively. BDI-II scores > 13 indicating at least mild depressive symptoms were present in 142 (88.7%) patients and 52 (28.1%) patients had a positive screen for PTSD (PCL-5 score >= 38). On multivariable analysis, depression [OR 2.17 (95% CI 1.045-4.489), p = 0.038], anxiety disorder [OR 2.232 (95% CI 1.066-4.676), p = 0.033], and being unemployed [OR 2.234 (95% CI 1.46-4.714), p = 0.019) were associated with PTSD.Conclusion: We report a high prevalence of depressive and PTSD symptoms in individuals with HHT. While selection bias may lead to overestimation of prevalence in this study, our results are concerning and clinicians should remain vigilant for signs of psychological distress and consider screening for these disorders. (C) 2017 Elsevier Ltd. All rights reserved.