Löwe Bernd, Gräfe Kerstin, Ufer Christiane, Kroenke Kurt, Grünig Ekkehard, Herzog Wolfgang, Borst Mathias M
Department of General Internal and Psychosomatic Medicine, University of Heidelberg, Medical Center, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany.
Psychosom Med. 2004 Nov-Dec;66(6):831-6. doi: 10.1097/01.psy.0000145593.37594.39.
This is the first study that investigates the prevalence and actual treatment of anxiety, depression, and other mental disorders in patients with pulmonary hypertension (PH). The prevalence of mental disorders in patients with PH was compared with parallel groups of primary care patients and patients with inflammatory rheumatic diseases, and the relationship between functional status and prevalence of mental disorders was determined.
The patient group with PH (70.1% female; mean age, 47.8 +/- 12.7 years) and the two comparison groups, which were matched by age and sex, consisted of 164 patients each. Patients completed self-administered instruments, including the Patient Health Questionnaire for the diagnosis of mental disorders. New York Heart Association (NYHA) functional class was assessed in all patients with PH.
Thirty-five percent of the patients with PH suffered from mental disorders, with the most common being major depressive disorder (15.9%) and panic disorder (10.4%). Both panic disorder and panic attacks were significantly more prevalent in patients with PH than in either patients with inflammatory rheumatic diseases or primary care patients. The prevalence of mental disorders in patients with PH increased significantly with functional impairment, from 17.7% (NYHA class I) to 61.9% (NYHA class IV). Only 24.1% of the patients with PH with mental disorders were receiving psychopharmacological or psychotherapeutic treatment.
Anxiety and depression are frequent in patients with PH and increase as the severity of disease progresses. Given the fact that safe and efficacious treatments of mental disorders are available, greater importance should be attached to the diagnosis and treatment of these conditions in patients with PH.
本研究首次调查肺动脉高压（PH）患者中焦虑、抑郁及其他精神障碍的患病率和实际治疗情况。将PH患者中精神障碍的患病率与初级保健患者及炎性风湿性疾病患者的平行组进行比较，并确定功能状态与精神障碍患病率之间的关系。
PH患者组（女性占70.1%；平均年龄47.8±12.7岁）和两个按年龄和性别匹配的对照组，每组各有164名患者。患者完成自我管理的量表，包括用于诊断精神障碍的患者健康问卷。对所有PH患者评估纽约心脏协会（NYHA）功能分级。
35%的PH患者患有精神障碍，最常见的是重度抑郁症（15.9%）和惊恐障碍（10.4%）。惊恐障碍和惊恐发作在PH患者中的患病率显著高于炎性风湿性疾病患者或初级保健患者。PH患者中精神障碍的患病率随功能损害程度显著增加，从NYHA I级的17.7%增至NYHA IV级的61.9%。患有精神障碍的PH患者中只有24.1%正在接受精神药物治疗或心理治疗。
焦虑和抑郁在PH患者中很常见，并随着疾病严重程度的进展而增加。鉴于有安全有效的精神障碍治疗方法，应更加重视PH患者中这些疾病的诊断和治疗。
