Post-traumatic stress disorder and depression in survivors of thrombotic thrombocytopenic purpura

Shruti Chaturvedi, Olalekan Oluwole, Spero Cataland, Keith R. McCrae

Research output: Contribution to journalArticle

Abstract

Introduction Survivors of thrombotic thrombocytopenic purpura (TTP) have high rates of chronic morbidities including neurocognitive complications and depression. There is limited information regarding the psychological consequences of TTP. We conducted this cross sectional study to estimate the prevalence of symptoms of PTSD and depression in survivors of TTP. Methods An online 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 TTP. Multivariable regression was used to identify clinical and demographic associations of depression and PTSD. Results A total of 236 individuals completed either the BDI II or PCL-5 and were included in the analysis. Median age was 44 years and 87.3% were female. Median time from diagnosis was 80 months. BDI-II scores > 13 indicating at least mild depressive symptoms were present in 80.8% individuals (15.8%, 28.2%, and 36.8% with mild, moderate and severe symptoms, respectively) and 35.1% had a positive screen for PTSD (PCL-5 score ≥ 38). A previous diagnosis of depression [OR 3.65 (95% CI 1.26–10.57); p = 0.017] and unemployment attributed to TTP [OR 5.86 (95% CI 1.26–27.09); p = 0.024] were associated with depression. Younger age (p = 0.017), a pre-existing anxiety disorder [OR 3.57 (95% CI 1.76–7.25), p < 0.001], and unemployment attributable to TTP [OR 6.42 (95% CI 2.75–415.00), p < 0.001] were associated with PTSD. Conclusion We report a high prevalence of PTSD and depression in TTP survivors. These results are concerning and indicate a need for further investigation to better define this association and its consequences.

Original languageEnglish (US)
Pages (from-to)51-56
Number of pages6
JournalThrombosis Research
Volume151
DOIs
StatePublished - Mar 1 2017
Externally publishedYes

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Thrombotic Thrombocytopenic Purpura
Post-Traumatic Stress Disorders
Survivors
Depression
Checklist
Unemployment
Demography
Equipment and Supplies
Preexisting Condition Coverage
Anxiety Disorders
Cross-Sectional Studies
Psychology
Morbidity

Keywords

  • Depression
  • Post-traumatic stress disorder
  • Quality of life
  • Survivorship
  • Thrombotic thrombocytopenic purpura

ASJC Scopus subject areas

  • Hematology

Cite this

Post-traumatic stress disorder and depression in survivors of thrombotic thrombocytopenic purpura. / Chaturvedi, Shruti; Oluwole, Olalekan; Cataland, Spero; McCrae, Keith R.

In: Thrombosis Research, Vol. 151, 01.03.2017, p. 51-56.

Research output: Contribution to journalArticle

Chaturvedi, Shruti ; Oluwole, Olalekan ; Cataland, Spero ; McCrae, Keith R. / Post-traumatic stress disorder and depression in survivors of thrombotic thrombocytopenic purpura. In: Thrombosis Research. 2017 ; Vol. 151. pp. 51-56.
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abstract = "Introduction Survivors of thrombotic thrombocytopenic purpura (TTP) have high rates of chronic morbidities including neurocognitive complications and depression. There is limited information regarding the psychological consequences of TTP. We conducted this cross sectional study to estimate the prevalence of symptoms of PTSD and depression in survivors of TTP. Methods An online 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 TTP. Multivariable regression was used to identify clinical and demographic associations of depression and PTSD. Results A total of 236 individuals completed either the BDI II or PCL-5 and were included in the analysis. Median age was 44 years and 87.3{\%} were female. Median time from diagnosis was 80 months. BDI-II scores > 13 indicating at least mild depressive symptoms were present in 80.8{\%} individuals (15.8{\%}, 28.2{\%}, and 36.8{\%} with mild, moderate and severe symptoms, respectively) and 35.1{\%} had a positive screen for PTSD (PCL-5 score ≥ 38). A previous diagnosis of depression [OR 3.65 (95{\%} CI 1.26–10.57); p = 0.017] and unemployment attributed to TTP [OR 5.86 (95{\%} CI 1.26–27.09); p = 0.024] were associated with depression. Younger age (p = 0.017), a pre-existing anxiety disorder [OR 3.57 (95{\%} CI 1.76–7.25), p < 0.001], and unemployment attributable to TTP [OR 6.42 (95{\%} CI 2.75–415.00), p < 0.001] were associated with PTSD. Conclusion We report a high prevalence of PTSD and depression in TTP survivors. These results are concerning and indicate a need for further investigation to better define this association and its consequences.",
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AU - Chaturvedi, Shruti

AU - Oluwole, Olalekan

AU - Cataland, Spero

AU - McCrae, Keith R.

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N2 - Introduction Survivors of thrombotic thrombocytopenic purpura (TTP) have high rates of chronic morbidities including neurocognitive complications and depression. There is limited information regarding the psychological consequences of TTP. We conducted this cross sectional study to estimate the prevalence of symptoms of PTSD and depression in survivors of TTP. Methods An online 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 TTP. Multivariable regression was used to identify clinical and demographic associations of depression and PTSD. Results A total of 236 individuals completed either the BDI II or PCL-5 and were included in the analysis. Median age was 44 years and 87.3% were female. Median time from diagnosis was 80 months. BDI-II scores > 13 indicating at least mild depressive symptoms were present in 80.8% individuals (15.8%, 28.2%, and 36.8% with mild, moderate and severe symptoms, respectively) and 35.1% had a positive screen for PTSD (PCL-5 score ≥ 38). A previous diagnosis of depression [OR 3.65 (95% CI 1.26–10.57); p = 0.017] and unemployment attributed to TTP [OR 5.86 (95% CI 1.26–27.09); p = 0.024] were associated with depression. Younger age (p = 0.017), a pre-existing anxiety disorder [OR 3.57 (95% CI 1.76–7.25), p < 0.001], and unemployment attributable to TTP [OR 6.42 (95% CI 2.75–415.00), p < 0.001] were associated with PTSD. Conclusion We report a high prevalence of PTSD and depression in TTP survivors. These results are concerning and indicate a need for further investigation to better define this association and its consequences.

AB - Introduction Survivors of thrombotic thrombocytopenic purpura (TTP) have high rates of chronic morbidities including neurocognitive complications and depression. There is limited information regarding the psychological consequences of TTP. We conducted this cross sectional study to estimate the prevalence of symptoms of PTSD and depression in survivors of TTP. Methods An online 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 TTP. Multivariable regression was used to identify clinical and demographic associations of depression and PTSD. Results A total of 236 individuals completed either the BDI II or PCL-5 and were included in the analysis. Median age was 44 years and 87.3% were female. Median time from diagnosis was 80 months. BDI-II scores > 13 indicating at least mild depressive symptoms were present in 80.8% individuals (15.8%, 28.2%, and 36.8% with mild, moderate and severe symptoms, respectively) and 35.1% had a positive screen for PTSD (PCL-5 score ≥ 38). A previous diagnosis of depression [OR 3.65 (95% CI 1.26–10.57); p = 0.017] and unemployment attributed to TTP [OR 5.86 (95% CI 1.26–27.09); p = 0.024] were associated with depression. Younger age (p = 0.017), a pre-existing anxiety disorder [OR 3.57 (95% CI 1.76–7.25), p < 0.001], and unemployment attributable to TTP [OR 6.42 (95% CI 2.75–415.00), p < 0.001] were associated with PTSD. Conclusion We report a high prevalence of PTSD and depression in TTP survivors. These results are concerning and indicate a need for further investigation to better define this association and its consequences.

KW - Depression

KW - Post-traumatic stress disorder

KW - Quality of life

KW - Survivorship

KW - Thrombotic thrombocytopenic purpura

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