Health Psychology, Universidad Autónoma de Madrid, Madrid, Spainb- School of Biomedical Sciences, Universidad Europea de Madrid, Madrid, Spain; Department of Biological and Health Psychology, Autonomous University of Madrid, Madrid, Spain; Asociación Nacional de Hipertensión Pulmonar, Madrid, Spain.
Department of Biological and Health Psychology, Autonomous University of Madrid, Madrid, Spain.
Psychosomatics. 2018 Nov;59(6):575-583. doi: 10.1016/j.psym.2018.04.002. Epub 2018 Apr 12.
Pulmonary hypertension is a highly disabling condition characterized by a progressive increase in pulmonary arterial pressure. Even though pulmonary hypertension may cause great emotional distress, research examining the determinants of patients' emotional well-being has been scarce and has mostly focused on the role of disease-related factors.
This study examined whether patients' emotional well-being may be effected by their life circumstances.
Sixty-four patients with pulmonary hypertension completed measures of symptoms of pulmonary hypertension, functional disability, depression and anxiety symptoms, life satisfaction, optimism, and quality of life (QoL).
Clinically-significant symptoms of depression and anxiety were only accurately predicted in 50.5% and 56.5% of patients, respectively, based on disease severity alone. However, the addition of life satisfaction and optimism to the models improved the prediction of depressive and anxiety symptomatology. Further, symptoms of anxiety were a significant predictor of QoL, above and beyond disease severity.
Patients with considerably different levels of disease severity may develop clinically-significant depressive and anxiety symptomatology. This suggests that there is not a perfect correspondence between the level of disease severity and the repercussions thereof across patients. Accordingly, these results suggest that emotional well-being may be better explained by taking into consideration patients' life circumstances, as these may modulate the repercussions of having pulmonary hypertension. The results also showed that anxiety symptoms constituted an extra burden to patients' QoL. The higher prevalence in this sample of clinically-significant symptoms of anxiety, compared to that of depression, suggest that feelings of fear and uncertainty may require special attention among patients with pulmonary hypertension.
肺动脉高压是一种高度致残的疾病，其特征是肺动脉压力逐渐升高。尽管肺动脉高压可能会给患者带来极大的情绪困扰，但研究其情绪健康的决定因素的研究却很少，而且大多集中在疾病相关因素的作用上。
本研究探讨了患者的生活环境是否会影响他们的情绪健康。
64 名肺动脉高压患者完成了肺动脉高压症状、功能障碍、抑郁和焦虑症状、生活满意度、乐观和生活质量（QoL）的测量。
仅根据疾病严重程度，分别只有 50.5%和 56.5%的患者准确预测出临床显著的抑郁和焦虑症状。然而，将生活满意度和乐观情绪纳入模型后，抑郁和焦虑症状的预测得到了改善。此外，焦虑症状是 QoL 的一个重要预测指标，超过了疾病严重程度的影响。
疾病严重程度差异很大的患者可能会出现临床显著的抑郁和焦虑症状。这表明，在不同患者中，疾病严重程度与疾病后果之间并非完全对应。因此，这些结果表明，考虑患者的生活环境可以更好地解释情绪健康，因为这些环境可能会调节患有肺动脉高压的患者的后果。结果还表明，焦虑症状给患者的 QoL 带来了额外的负担。与抑郁相比，本样本中焦虑症状的临床显著症状更为常见，这表明在肺动脉高压患者中，恐惧和不确定性的感觉可能需要特别关注。
