Lepsy Nicole, Dering Madelaine-Rachel, Fuge Jan, Meltendorf Tanja, Hoeper Marius M, Heitland Ivo, Kamp Jan C, Park Da-Hee, Richter Manuel J, Gall Henning, Ghofrani Hossein A, Ellermeier Dietmar, Kulla Hans-Dieter, Olsson Karen M, Kahl Kai G
Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany.
Front Psychiatry. 2022 Feb 24;13:821468. doi: 10.3389/fpsyt.2022.821468. eCollection 2022.
Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially life-threatening condition associated with high morbidity and mortality. However, advances in medical, surgical and interventional treatment have markedly improved the outcome of patients with CTEPH. Additional factors potentially influencing quality of life (QoL) and outcome in CTEPH are yet to be defined. Child maltreatment is a major risk factor for unfavorable behavioral, mental as well as physical health outcomes and has been associated with decreased QoL. To date, no study assessed the impact of childhood trauma in patients with CTEPH.
Patients with CTEPH were invited to complete the Childhood Trauma Questionnaire (CTQ). Data were compared to prevalence data from the German population. Mental well-being was assessed using the Hospital Anxiety and Depression Scale (HADS) and quality of life was measured using the WHO Quality of Life Questionnaire (WHOQOL). Furthermore, lifestyle factors and physical health parameters were studied.Logistic regression analysis was used to investigate a possible impact of child maltreatment on markers of disease severity.
One-hundred and seven patients with CTEPH completed the CTQ. These patients reported higher rates of emotional abuse and physical abuse and emotional neglect compared to the German population while rates of physical neglect and sexual abuse did not differ between patients and German population with prevalence of 20.6% for emotional abuse, 20% for physical abuse, 22% for emotional neglect, 46% for physical neglect, and 6% for sexual abuse in patients with CTEPH. Higher CTQ scores were associated with anxiety symptoms as well as negatively associated with QoL. No direct impact of childhood trauma on CTEPH severity was found.
We found a higher rate of child maltreatment in patients with CTEPH in comparison to the German population. Correlations suggest moderate associations between CTQ scores and mental health and QoL. Child maltreatment had no significant impact on disease severity. Further investigation on proper interventions to support affected patients is needed.
慢性血栓栓塞性肺动脉高压（CTEPH）是一种潜在的危及生命的疾病，具有较高的发病率和死亡率。然而，医学、外科和介入治疗的进展显著改善了CTEPH患者的预后。其他可能影响CTEPH患者生活质量（QoL）和预后的因素尚未明确。儿童期受虐是导致不良行为、心理和身体健康结果的主要危险因素，并且与生活质量下降有关。迄今为止，尚无研究评估童年创伤对CTEPH患者的影响。
邀请CTEPH患者完成儿童期创伤问卷（CTQ）。将数据与德国人群的患病率数据进行比较。使用医院焦虑抑郁量表（HADS）评估心理健康状况，使用世界卫生组织生活质量问卷（WHOQOL）测量生活质量。此外，还研究了生活方式因素和身体健康参数。采用逻辑回归分析来研究儿童期受虐对疾病严重程度指标的可能影响。
107例CTEPH患者完成了CTQ。与德国人群相比，这些患者报告的情感虐待、身体虐待和情感忽视发生率更高，而身体忽视和性虐待发生率在患者和德国人群之间没有差异，CTEPH患者中情感虐待的患病率为20.6%，身体虐待为20%，情感忽视为22%，身体忽视为46%，性虐待为6%。较高的CTQ分数与焦虑症状相关，并且与生活质量呈负相关。未发现童年创伤对CTEPH严重程度有直接影响。
我们发现CTEPH患者的儿童期受虐率高于德国人群。相关性表明CTQ分数与心理健康和生活质量之间存在中度关联。儿童期受虐对疾病严重程度没有显著影响。需要进一步研究适当的干预措施以支持受影响的患者。
