TY - JOUR
T1 - Depression and post-traumatic stress disorder in individuals with hereditary hemorrhagic telangiectasia
T2 - A cross-sectional survey
AU - Chaturvedi, Shruti
AU - Clancy, Marianne
AU - Schaefer, Nicole
AU - Oluwole, Olalekan
AU - McCrae, Keith R.
N1 - Funding Information:
We would like to recognize the contributions of CureHHT and the patients who participated in this study. This work was supported in part by NIH U34 HL123416 (to KRM) and an ASH RTAF (to SC). The RedCap tool used for this study is supported by NCATS/NIH UL1 TR000445 (Vanderbilt Institute for Clinical and Translational Research).
Publisher Copyright:
© 2017
PY - 2017/5/1
Y1 - 2017/5/1
N2 - 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.
AB - 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.
KW - Bleeding disorder other than hemophilia
KW - Depression
KW - Epistaxis
KW - Hereditary hemorrhagic telangiectasia
KW - Post-traumatic stress disorder
KW - Quality of life
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U2 - 10.1016/j.thromres.2017.03.003
DO - 10.1016/j.thromres.2017.03.003
M3 - Article
C2 - 28314138
AN - SCOPUS:85015102290
VL - 153
SP - 14
EP - 18
JO - Thrombosis Research
JF - Thrombosis Research
SN - 0049-3848
ER -